- Monopolists: avoid silencing the client outright or removing them from the group. Encourage the monopolist to discuss personal difficulties with the group and gain insight into their in-group behavior. Question and discuss why other group members contribute less. Sit next to the monopolized to minimize direct eye contact. Allow space to talk and ask more focused questions.
- Silent Clients: periodically include the client by commenting on their nonverbal behavior, e.g., interest, boredom. Encourage other members to reflect on their own silence. Encourage client autonomy and responsibility in the group with periodic prodding. Reinforce group guidelines for participation.
- Boring Clients: encourage more spontaneity by removing the barriers to the client’s free expression.
- Complainers who seek help but reject suggestions: empathize with the client and share their feelings of hopelessness, but avoid mockery and humiliation. Encourage interpersonal learning by focusing on feedback from other members.
- Psychotic Clients: confront the issue of why other members may fear upsetting the psychotic client. Avoid dismissing the group if a client becomes psychotic later in the course of a mature group. Allow the group to share the decision and be involved in how to handle a crisis and intervene when appropriate.
- Schizoid Clients: encourage the client to observe their own body and their symptoms. Allow them to time to develop their social skills and to express their emotions.
- Borderline Clients: offer emotional support and provide opportunities for interpersonal learning. Hold the client accountable. Encourage feedback and observation. Allow the client to withdraw and rest. Consider both individual and group treatment. Avoid solely individual therapy.
- Narcissistic Clients: consider rewatching videotapes of previous sessions to provide insight into behaviors. Maintain an empathetic connection. Allow other members to provide reality testing to the client, but maintain respect and avoid patronizing the client.
Other Recommendations
- Avoid groupthink and encourage debate and opinions, but avoid too much conflict as it can cause emotional distress and communication barriers.
- Promote conflict management with a collaborative approach instead of conflict resolution for conflicts that cannot be resolved.
- Have an awareness of transference (client responds to another based on past responses) and counter-transference (group leader responds towards a group member based on responses from their own past relationships).
References
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group therapy (5th ed.). New York, NY: Basic Books.
Seymour, A. (2010). Managing group dynamics and developing team working in problem-based learning. Problem-based learning in health and social care, 67-78.