Responding To Problems In The Support Group Setting
by Alan D. Wolfelt, Ph.D.
Editor's note: The following article is excerpted from Dr. Wolfelt's book How to Start and Lead a Bereavement Support Group, available from Companion Press.
Murphy's Law ensures that no bereavement support group will run smoothly 100 percent of the time. Problems will arise, typically due to one of three reasons:
- Lack of leader preparation. "Where are we supposed to meet?" "How long was this meeting supposed to last?" "I thought you were going to bring the name tags!" If admini strative details aren't properly taken care of, group members will feel left in the lurch. On the other hand, problems can also arise when a leader is too controlling. In general, a lack of effective leadership skills can result in a number of negative consequences. Proper bereavement support group facilitator training will help you circumvent these problems.
- Discrepancy between group members' expectations and leader's expectations. Each individual group member will have his or her own expectations for the group. The place to vocalize these various expectations is in your pre-screening process and during the drafting of the group ground rules. Without clarifying mutual expectations, the group is set up for failure.
- Individual participant problems. Each person brings a unique personality and history to the group. No matter how well you pre-screen members, you will encounter challenging participants who will test your skills as a group leader. Effective intervention in these cases requires that you first establish a caring, trusting relationship between you and each group member. Â Sometimes group members will themselves intervene by confronting each other about problems arising in the group.
Let's meet a few of these challenging folks:
Amy the Absent
Amy is the group member who is there, but is not there. Sometimes this person is still in the initial shock wave from the death and is simply unable to speak. Amy may have tried to attend the support group too early in her grief journey, or she may just need the group to be patient and understanding. However, there are also Amys who consciously choose not to participate and interact with the group in passive-aggressive ways: "I'm here, but I don't plan to be a part of this group."
Appropriate ways to intervene: From the very first session on, make an effort to help everyone feel involved and a part of the group. Create safe ways to invite the Amys in, such as asking, "Amy, I'm wondering what your week has been like since we met last?" Making eye contact even when this person is quiet is also a way of engaging her and inviting her participation. If your Amy is an outright passive-aggressive, you may need to talk to her individually and explore whether the group can appropriately meet her needs at this time. You may discover that some people are just very shy, quiet or overwhelmed - yet they perceive they are getting a lot out of the group experience. If you can sometimes help them let the group know this, the group can often embrace and accept them for the quiet people they are.
Ann the Advice-Giver
Even though you have created a ground rule that says, "Do not give advice unless it is asked for," you will, no doubt, have an Ann in one of your groups sometime. Ann is quick to inform others what they should do to solve problems. She may try to "take over" under the guise of being helpful.
Appropriate ways to intervene are to gently remind Ann of the ground rule about advice-giving or to ask "Did you feel that John needed you to tell him what to do about his concerns?" Obviously, the goal is to prevent advice-giving in your group unless it is asked for. We know that many bereaved people resent unsolicited advice.
Albert the Academic
Albert is the intellectual in the group and often likes to show off his huge knowledge base. He might quote a recent article he read or expose a little-known theory to explain his, or more likely someone else's, behavior. Analysis and interpretation are Albert's joys in life! There may be a condescending quality to his tone; generally he thinks he knows more than most anyone else in the group.
Appropriate ways to intervene: Initially, I often allow Albert's natural defense mechanism to help him ease into the group. However, when it becomes a consistent pattern, it can be destructive to the group. Therefore, I sometimes try saying things like, "Albert, you have really helped us understand what the articles say, but sometimes I wonder how you feel." Of course, he may lack insight, but it is worth a try. Sometimes when I know my relationship with Albert is strong I'll say, "Albert, I know that I sometimes have a tendency to intellectualize things that are painful for me. I wonder if you see that same tendency in yourself?"
Bob the Blamer
Bob is the participant who projects that other group members (or, other people in general) are the ones who cause his problems. This self-defeating thought pattern has often been a part of his coping mechanisms for some time. Bobs often projects an accompanying sense that no one has ever understood him and no one ever will. This self-crippling stance wears thin very quickly with members who are trying to honestly look at themselves and sort out new directions in their lives.
Appropriate ways to intervene: Compassionately attempt to help Bob become more self-responsible and eliminate the tendency to blame. Well-timed, tentative comments like, "Bob, sometimes I'm struck by how often you find fault with others. I'm wondering what would happen for you if you looked inside yourself at times instead of outside?" A supportive confrontation like this has the potential of getting Bob more connected to himself and starts to help him make positive changes.
Charlene the Challenging
Charlene is the participant who likes to challenge the leader. She might accuse you of not knowing what you are doing, which in turn may cause you to question yourself. Charlene likes to put you on the spot and tries to make you look incompetent in the eyes of group. Her challenges are more often made in front of the group instead of privately.
Appropriate ways to intervene: Be certain you don't get defensive when the challenges come forth. This would be just what Charlene wants and would probably lead to more challenges. It is often appropriate to acknowledge her comment, but then offer to meet her after the group to better understand each other. While you may be tempted to initiate a dialogue that will prove your competence, resist the urge. The group will most often respect your decision to deflect the criticism and discuss the situation individually with Charlene.
Fred the Forced Fred is the group member who is there because someone else wants him there. He has no intention of participating and feels he is being forced by a spouse or friend. He hopes everyone will forget he is present and will leave him alone. Fred rarely makes eye contact with anyone, particularly the group leader. If questioned or invited to participate, he often passes and looks put upon. If Fred is attending with his spouse or friend, he often defers the question to them.
Appropriate ways to intervene: Try to screen this person out in your pre-screening process because this person will be counterproductive if not outright damaging to the group. Once Fred is in the group, you can attempt to make him feel welcome and warmly invite his participation. However, if that doesn't work, the group will be well-served if you meet with Fred individually and explore the possibility of him leaving the group. You may also consider referring Fred to individual counseling, but he will usually resist this suggestion.
Holly the Holy Roller
Holly spends so much time talking about heaven that people wonder if her feet are on the ground! While faith values are very important and should be explored, the Hollys of the group often alienate other members by quoting scripture. Holly usually projects a lack of any personal problems and may perceive other members' pain as a "lack of faith."
Appropriate ways to intervene: Support that what works for one person may not work for another. You can accept how important Holly's faith is to her while also (with appropriate timing and pacing) helping her and the group acknowledge that having faith and mourning are not mutually exclusive. If Holly is advice-giving about the need for everyone to have faith like hers, you must gently remind her of the ground rules and redirect the group in ways supportive to everyone present.
Ivan the Interrupter
Ivan is the group member who, consciously or unconsciously, is always interrupting other people. He can't seem to keep his mouth shut. Other participants will begin to see it coming and will start hesitating to share for fear they will be interrupted. Ivan must be helped to control his interrupting tendencies or he will destroy the very heart of the group.
Appropriate ways to intervene: Gently remind Ivan of the "equal time" ground rule. When this fails, go to the next step: "Ivan, I notice that sometimes you have a tendency to interrupt the person who is talking. Are you aware of this?" You can then offer to help him when he does interrupt; it can often be done in good humor with excellent results.
Paul the Preacher
Paul has a lot in common with Holly, but he often preaches about anything and everything. The group experience provides Paul with an audience. He may attempt to dominate the group as he tells the group what they should and should not do. He is usually very well-intentioned, but tends to wear thin with the group. He may seem overly rehearsed, as if he has preached his message many times.
Appropriate ways to intervene: Gently remind Paul of the "equal time" ground rule, as well as the "advice-giving" ground rule. You might express how his tendency to preach impacts you. Say, for example, "Sometimes when I listen to you, Paul, I wonder if you really want to hear what others think and feel." Again, this confrontation must be well-timed and intended to help him reflect on how he is impacting the group.
Ralph the Rambler
Ralph is a close cousin of Paul the Preacher - he just changes subjects more often. Ralph tends to bore the group as he rambles on, yet seems to say little of substance related to the needs of the group. He rarely completes his sentences in ways that allow others to talk; he just keeps running on and on and on. The group kind of lets out a silent groan as soon as Ralph utters his first words. Without a doubt, one rambling Ralph can ruin your group if you don't effectively intervene.
Appropriate ways to intervene: Once again, return to the ground rules related to "equal time." If this fails, step up your efforts to help Ralph by being supportively direct about his tendency to talk a lot. The group will often be able to help if you ask them if anyone was able to follow what Ralph just said. There is some risk in this approach in that a fellow group member may attack Ralph for rambling on all the time and saying little. Again, if all else fails, ask to speak with Ralph after the meeting and attempt to compassionately help him look at his rambling and become a more controlled contributor to the group.
Sarah the Socializer
Sarah's goal is to keep the group from getting too serious about anything. The problem here, of course, is that grief will bring about serious, thoughtful, painful discussions. Sarah may see the group as an opportunity to be with other people and socialize in a fun way. Obviously, her expectations are different than the group's. Sarah may laugh when everyone else is sad or make inappropriate comments to distract the group from the work at hand.
Appropriate ways to intervene? First, understand that many people protect themselves from getting hurt by trying to stay in a social mode or be humorous. Try well-timed, sensitive comments like, "I notice that sometimes you laugh when others are sad. How do you understand that about yourself?" Or, "When I see you laugh like that, I wonder what you are feeling?" Some Sarahs will lack insight into their use of socializing while others will appropriate your efforts to help them.
Wally the We-Sayer
Wally attempts to talk for everyone in the group or to be the group spokesperson. "We think we should . . ." is a common lead for this person. Wally assumes (and this is what creates problems) that everyone thinks and feels the same as he does. Allowing the "we" messages to continue often causes quieter members to give in to the "we talk" Wally espouses. Resentment can grow and some members will probably drop out and not even tell you why.
Appropriate ways to intervene include asking Wally if he is speaking for every person in the group or asking the group if there is anyone who doesn't agree with Wally's statement. If it is healthy, your group will provide a safe atmosphere for people to express their unique personalities. Gently confronting Wally often helps achieve that goal.
Red Flags Suggesting Referral for Individual Counseling
There are some bereaved persons whose needs will be met more effectively in individual counseling or therapy. The following "red flags" should alert you to the need for making an appropriate referral.
- Expression of suicidal intent
- A pattern of alcohol abuse/dependence
- Inability to care for self (not getting sleep, not eating)
- Uncontrollable rage directed at others
- Physical harm to self or others
- Uncontrollable phobias, such as an inability to be by themselves at any time
- Characteristics of mourning do not appear to change at all over a period of months
Of course, the above list is not all-inclusive. You should use your good judgment as to whether or not a group member would benefit more from individual counseling than from a support group.