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SMALL-GROUP COUNSELLING WITH PRIMARY SCHOOL CHILDREN
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Deborah
Truneckova and Linda L. Viney |
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School
of Psychology, University of Wollongong, Wollongong, NSW, Australia
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Abstract
A
model of group work, based on personal construct theory, was developed for children
aged between 8 to 12 years, attending school. Integrating the psychological
needs of the children, counsellor skills and expertise, and criteria needed for
treatment research, data were sought on changes to construing and behaviour,
and on group processes, before and after the intervention. The rationale behind
the use of these outcome measures is provided, along with a discussion of the
results. The treatment efficacy and clinical utility of this approach, as
necessary dimensions of evidence-based practice, are discussed. Finally, the
clinical implications of this counselling treatment approach with primary
school children, is explored.
Keywords: group processes, personal construct theory, children.
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Drawing on a range of psychological models
of practice, group work for primary school age children has been increasingly
taken out of specialised clinics and into school-settings (Auger, 2004; Crespi,
Gustafson, & Borges, 2005; Kulic, Horne, & Dagley, 2000; Littrell,
& Peterson, 2002; McArdle, Moseley, & Quibell, 2002; Riva, & Haub,
2004; Shechtman, 2002; Slavin, 2002). Evidence-based practice has generally
targeted specific diagnostic groups of children, such as, the treatment of
anxiety (e.g. Spence, Donovan, & Brechman-Toussaint, 2000), depression (e.g.
Weisz, Thurber, Sweeney, Proffitt, & Le Gagnoux, 1997), and grief (Johnson,
2006), or in developing particular skills of empathy (Akos, 2000), of emotional
resilience (Barrett, & Turner, 2001; Barrett, & Shortt, 2003), social
skills (Aurelio, 2004; Campbell, 2003; DeRosier, 2004), and developing
emotional intelligence (Pummell, 2003). While personal construct group work has
been found to be an effective counselling intervention for clients of different
ages and clinical problems (e.g. Jackson, 1992a, 1992b; Metcalfe, Winter, &
Viney, in press; Truneckova, & Viney, 2001, 2005, 2006, 2007; Viney, 1998;
Viney, & Henry, 2002; Viney, Henry, & Campbell, 2001; Viney, Metcalfe,
& Winter, 2005; Viney, Truneckova, Weekes, & Oades, 1997; Viney,
Truneckova, Weekes, & Oades, 1999), few investigations have been directed
at the effectiveness of personal construct group work with children.
We will describe a counselling model of
group work with primary school students, striving to meet the criteria provided
by the APA Task Force (APA, 2005; 2006) on evidence-based practice, of
treatment efficacy and clinical utility. The principles of learning centred
counselling (LCP; APA, 1997) are central to the model, where diversity is
integral to the group counselling processes, the learning experience is
meaningful and relevant to the group members, the group experience emphasizes
dialogue, negotiation, and mutual feedback, the group leader’s role is one of
facilitator, and evaluation of the group experience is largely self-reflective
(Stroh, & Sink, 2002). The effectiveness of this model of small-group
counselling with primary school children was tested by measuring changes in
social skills and self-esteem, and investigations were also undertaken into the
group processes.
AIMS
The aims of these group counselling
interventions are to investigate the treatment efficacy and clinical utility of
personal construct group counselling for students with interpersonal
difficulties.
1. | to explore the changes in
social skills and self-esteem of students participating in group counselling. | 2. | to inquire into the processes
of personal construct group counselling. |
HYPOTHESIS
Individual
Changes
Changes
in social skills
After group counselling, there will be an
increase in effective social skills as reported by the students, and their
teachers.
Changes
in self-esteem
After group work, there will be an increase
in self-esteem as reported by the students.
Group
processes
After each group counselling session and at
Time 2, the group members will indicate that they felt in the groups that:
a)
others listened to them
b)
they belonged
c)
they were understood
d)
they became stronger in
themselves
e)
they became more
self-confident.
METHOD
Participants
Fifteen students attending three government
primary schools in New South Wales, Australia,
have participated in small group work. The students, three girls and twelve
boys aged between 8 years to 11 years (M=9.93 years, S.D.=1.73), were
representative of the range of students in their school population, and of
other students attending primary schools in the region (Department of School
Education, 2006). The demographic data for the participating students reported
40% from intact families, 53% from sole parent or blended families, 7% were in
care, and no children identified themselves as Aboriginal or speaking a
language other than English.
The students were referred by their
teachers in consultation with their parents/carers. The students were described
by their teachers and parents as demonstrating poor social skills resulting in
either frequent conflict with peers, or social isolation from peers. Informed
consent was gained from the participants, and their parents/carers, the group
work being offered as a positive way to make some helpful changes in the
student’s behaviour at school. The first author was the group leader for all
groups. Monthly clinical supervision took place.
Group
work
Counselling service in the three
participating schools was on a weekly basis for one school, and a fortnightly
basis for the two other schools. Accordingly, the group work was conducted on a
weekly or fortnightly basis, for 30 minutes or 45 minutes respectively. Each of
the five groups of 3 students were closed, and the number of sessions ranged
from 9 to 33 sessions (refer Table 1). The psychological intervention was based
in personal construct theory, also drawing on an analytic approach (Cousens,
1999), where therapeutic space and containment are maintained by a structured
group environment. With general goals of improving social and communication
skills, the overall theme was of listening and trying to understand what the
other member was saying. The group rules were: maintain confidentiality, each
person has their own point of view, we need to listen to each other, we try to
get along with each other, and we avoid interrupting others (Truneckova &
Viney, 2007).
Table 1: Description of the Group Work Interventions
Group | Age
(years) | Gender | Frequency
of group | Number
of sessions | Duration
of group (months) | 1. | 8-9 | boys
| fortnightly
| 9 | 5 | 2. | 9-10 | boys
| fortnightly
| 10 | 5 | 3. | 9-11 | girls
| weekly
| 33 | 12 | 4. | 11
| boys
| weekly
| 26 | 10 | 5. | 10-11 | boys
| fortnightly
| 11 | 6 |
As goal setting is integral to process and
effectiveness (Stroh & Sink, 2002), eight working goals were developed
(Kelly, 1991a; 1991b), and used to evaluate the group processes through the
Group Session Evaluation. The themes incorporated in the goals were: to provide
confirmation; to facilitate a sense of belonging and a sense of feeling
understood; to develop trust; to share meanings; to formulate hypotheses and
design experiments leading to change in meanings; to explore similarities and
differences in and outside the group; to apply group experiences to everyday situations;
and to grow in self-esteem.
The group work began with the participants filling
in the top section of their session evaluation sheet, then telling news, and asking
questions of the news-giver, followed by the members taking part in the group
activity, and reporting on the group activity to the group, and finally the
members completing the session evaluation sheet. Depending on the group members’
abilities to articulate their feelings and thoughts, the group activity focused
on either a verbal or nonverbal task(s). The structure of the group activity
for each session, involved each participant being the group leader, and as the
group leader for that session they would choose the theme for the activity such
as friendly/unfriendly, playing together/fighting, and they would also choose
the medium to be used, for example ‘play doh’, drawing, painting, craft,
turn-taking games. As group leader, they would then report on the group’s
achievement(s), and lead the discussion of the theme being tested through their
activities.
Outcome
measures
Measures to assess change
Three measures were used to assess
individual change, the Social Skills Rating System (SSRS), the Self Image
Profiles (SIP), and the Coopersmith Self-Esteem Inventories (CSEI). All
measures when administered, were read aloud to each child.
Instruments
The Social Skills Rating System, (SSRS)
(Gresham & Elliott, 1990) was developed in the United States of America to
assess social behaviours of children 3 to 18 years using three rating report
forms, parent, teacher, and student, with separate forms for preschoolers,
primary age children, and adolescents. The instrument consists of three scales,
the Social Skills Scale on all report forms, the Problem Behaviors Scale on the
parent and teacher report forms, and the Academic Competence Scale on the
teacher report form only. For this group work intervention, the teacher and
student forms only were administered.
The reliability and validity of the SSRS
has been reported extensively by the authors, reporting high reliability for
the total scores across Teacher, Parent and Student Forms. The Teacher Forms
showed the highest degree of reliability, internal consistency, coefficients
and test-retest correlations ranging from .82 to .95, followed by Parent and
Student forms. Several methods were used to test construct validity. Items were
found to intercorrelate highly with median internal consistency reliabilities
(coefficient alpha) of .90 for Social Skills, .84 for Problem Behaviors, and
.95 for Academic Competence on the Teacher Form. While not as high, there was
evidence of convergent and discriminant validity across teacher, parent, and
student raters (Social Skills total 0.31, p<.001 for teacher & parent
ratings; 0.32 p<.0001 for teacher & student ratings; 0.24 p<.001 for
parent & student ratings).
The second measure of individual change was
the Self Image Profiles (SIP), a brief self report measure with separate forms
for children and adolescents, providing both a visual display of self image and
self-esteem. The theoretical rationale behind the development of the profiles
is based on the notion of self as a personal construction, the child’s sense of
self is considered an interpretative act (Butler & Green, 1998). The SIP-C
provides a measure of Self Image by asking the child to first rate the ‘Actual
Self’ by indicating ‘How I am’ against each of the 25 items using a 0-6 Likert
type scale. Measures of Self Esteem are achieved by then asking the child to
rate the ‘Ideal Self’ by indicating ‘How I would like to be’ against the same
25 items using the same Likert scale. The discrepancy scores between ‘How I am’
and ‘How I would like to be’ provide an estimate of the child’s self-esteem
(Butler & Green, 1998; Harter, 1999).
Standardisation and validation of the
children’s form (SIP-C) involved 513 school children in Leeds, England.
Construct validity was determined by comparing the SIP-C with the Self
Perception Profile for Children (SPPC) developed by Harter (1985). The
significant relationship (p<.01), between the two measures indicated the
SIP-C self image and self-esteem scores were measuring the same theoretical
construct of self identity or concept as the SPPC. Reliability of the SIP-C was
explored and self consistency was found for both Positive Self Image and
Negative Self Image (p<.01, 2-tailed). Internal consistency using SIP-C
intercorrelations showed Positive Self Image largely concerned with ‘social’,
‘academic’, ‘outgoing’, and ‘appearance’ aspects of self, while Negative Self
Image was made up with ‘behaviour’, and ‘emotional’ aspects of self (Butler,
& Green, 2001).
The third measure of individual change, the
Coopersmith Self Esteem Inventories (CSEI) (Coopersmith, 1981), is a widely
used measure of evaluating self-concept (Peterson, 1985; Sewell, 1985), with school-age
children and adults. Coopersmith (1967) defined self-esteem as a personal
judgement of worthiness that is expressed in the attitudes children hold of
themselves. This instrument, a brief self-report questionnaire, assesses
attitude toward one self in general, as well as in social (peers), academic
(school), and home (parental) contexts. The child is asked to mark “like me” or
“unlike me” on a set of 58 favourable or unfavourable statements about the
child. The rationale behind the development of this measure is that the
construct of self-concept merges with certain related constructs designated as
self-esteem (Coopersmith, 1967, 1981). The reliability, stability, and
construct validity of the questionnaire has been supported by considerable
research (cited by Coopersmith, 1981).
Measures to assess group processes
The Group Session Evaluation (GSE) (see
Table 2), forming part of the structure of the sessions and serving as an
overview and review tool at the end of each session, was completed by the group
members. Considerable research has been undertaken into the efficacy and
effectiveness of psychotherapy (Lambert & Ogles, 2004; Miller, Duncan,
& Hubble, 2004), and tools have been developed to measure counselling
processes and outcomes. Inspired by these investigations, the GSE was developed
to follow and record the group processes and group work outcomes, through the
evaluations of the group session by the child. The GSE was designed to
investigate the self descriptions of the child, and how the child rated herself
or himself in terms of the supplied construct developed from the group work
goals.
Table 2: Group
session evaluation
NAME:_______________________ DATE:_____________
SESSION:_____
Now, I am feeling________________and I
am thinking__________________
| Yes | A Bit | No
| 1. Today I felt others listened to me. | | | | 2. Today I felt others were nice to me. | | | | 3. Today I understood more about me. | | | | 4. Today I felt more strong about myself. | | | | 5. Today I felt better about myself. | | | |
Now, I am feeling____________________and I
am thinking_______________
Developed over three years through pilot
studies, the current GSE measure has 5 supplied constructs and an ordinal scale
of ‘Yes’, ‘A Bit’, and ‘No’. At the beginning and at the end of the session,
the group members were asked to write down how they were feeling and thinking,
“Now, I am feeling…and I am thinking….” At the end of the session, they were
asked to indicate how they experienced the session by evaluating the session
using the supplied constructs.
DESIGN
The data from all the group work
interventions were pooled, and there was no examination to determine if there
were any differences in outcome measures and group processes between the
groups. This decision was taken because of the small size of the sample, and
the differences in total number of sessions. A repeated-measures design was
used to analyse data collected before the group work began (Time 1), and when
the group work ended (Time 2), for each dependent measure, and to test the
differences in the means. Descriptive statistics (number of responses,
percentages) were calculated, to show the evaluations by the members of the
group work process outcomes. The analyses of the data used the total raw scores
for the different scales on each of the measures. For the CSEI, the total raw
score was only used in the analysis. Currently, data are being collected to
evaluate the group work intervention twelve months later (Time 3).
RESULTS
Retention rates were good (93%), with one
member leaving to attend a school in another region.
Changes
in Social Skills
The data from the SSRS were analysed at
Time 1and Time 2 using the Paired Samples Tests. While there was a significant
increase in Social Skills reported by the teachers (t= 2.188, p< 0.025, one-tailed), a small to medium effect size
of 0.4 (Time 1, M= 86.9, S.D.= 8.62; Time 2, M= 90.6, S.D.= 10.52), the
students, however, did not report a significant increase. The data from the
SSRS-Teacher also reported a significant decrease by the students in Problem
Behaviors (t= 1.136, p< 0.10,
one-tailed), with a medium effect size of 0.6 (Time 1, M= 120.4, S.D.= 9.01;
Time 2, M= 114.9, S.D.= 12.81). The data from the SSRS-Teacher on Academic
Competence, reported a small increase in academic performance by the students.
Changes
in Self-Esteem
The Paired Samples Test was used to analyse
each of the eleven scores provided by the data of the SIP-C. The participants
reported a significant increase in Positive Self Image (t= 1.372, p< 0.10, one-tailed), a small to medium effect size of
0.3 (Time 1, M= 46.4, S.D.= 14.95; Time 2, M= 50.1, S.D.= 12.18), and a
significant decrease on Negative Self Image (t= 1.529, p< 0.10, one-tailed), a medium effect size of 0.5 (Time
1, M= 38.8, S.D.= 13.11; Time 2, M= 32.4, S.D.= 17.04). While there was an
increase in positive responses on Outgoing (aspect of Self Score), with a 0.4
medium effect size (Time 1, M= 13.3, S.D.= 3.88; Time 2, M= 14.7, S.D.= 4.91),
it was not significant. The members also responded with a significant decrease
on Resourceful (aspect of Self Score), (t=
3.101, p< 0.005, one-tailed), with a very large effect size of 1.24 ( Time
1, M= 5.4, S.D.= 1.45; Time 2, M= 3.6, S.D.= 2.14), indicating at Time 2, they
were not feeling as easily bored as they were at Time 1. The data from the SIP-C
also indicated that at Time 2, the participants were ‘liking more the way they
looked’, Appearance (aspect of Self Score). There was a significant increase (t= 2.066, p< .01, one-tailed), with a
moderate effect size of 0.64 (Time 1, M= 3.1, S.D.= 2.02; Time 2, M= 4.4, S.D.
=2.06).
The Paired Samples Test was also used to
analyse the data from the second tool used to measure changes in self-esteem,
the CSEI. There was a significant increase in self-esteem at Time 2 when
compared to the self reports at Time 1 (t=
3.143, p< .005, one-tailed), with a large effect size of 0.8 (Time 1, M=
50.8, S.D.= 16.80; Time 2, M= 64.1, S.D.= 19.41).
Changes
in Group Processes
The analysis of the members responses on
the GSEs was undertaken by pooling the responses to the two categories ‘Yes’
and ‘A Bit’, and comparing these responses over time, first Session of the
intervention (First Session), middle Session of the intervention (Middle Session),
and last Session of the intervention (Last Session). Percentages were
calculated at First Session, Middle Session and Last Session for each of the
five constructs (refer Table 3). The analysis of the members’ responses (Paired
Samples Test) supported the hypotheses, with evaluations ranging from 60-93% of
students giving a positive rating on the five supplied constructs at the end of
each session. However, the GSE revealed no overall significant increase in
positive responses at Time 2 compared to Time 1.
Table 3: The
number and percentages of the group members’ evaluations of the group sessions
at First Session, Middle Session, and Last Session, Rated as ‘Yes/ A Bit’,
using the Group Session Evaluation.
Construct
| First Session
N % | Middle Session
N % | Last Session
N % | 1. | 14 93 | 13 87 | 12 80 | 2. | 14 93 | 13 87 | 11 73 | 3. | 9 60 | 9 60 | 11 73 | 4. | 10 67 | 10 67 | 11 73 | 5. | 12 80 | 10 67 | 11 73 |
DISCUSSION
Personal construct small-group work was
found to be effective with primary school students. The results demonstrated
that there was an increase in positive social skills as reported by the
teachers of the participants. Evidence was also gained from the teachers’ reports
that the participants after the group work were engaging in fewer problematic
behaviours. Together, these measures demonstrate a consistent direction,
suggesting the intervention had an overall positive impact. While the teacher’s
judgements were not blind, this positive direction could also be demonstrating
construct validity in the test construction.
Although, the participants themselves only
reported a small increase in positive social skills at the completion of the
group work, they did report increases on the measures of self image and
self-esteem. The participants reported they felt more positive and less
negative about themselves after the group work. By identifying themselves more
positively after group work, they reported they felt more resourceful, and
liked better the way they looked. Supporting these reports of feeling more positive
about themselves, were also reports by the participants of positive increases
in their self-esteem after the group work. These increases in self-esteem while
not consistently reported across all the measures of self-esteem, were
significantly strong on one of the measures of self-esteem (CSEI).
While the group evaluation sheets were able
to capture the students’ immediate positive reactions to the group sessions,
they were not able to track the impact, the changes in social skills and
self-esteem were possibly having on the group processes. The students’
responses indicated that the group sessions on the whole were positive and
enjoyable, and most times they felt they belonged to the group and were
understood, that the group members listened to them, and they felt stronger in
themselves, and more self-confident.
While the results are encouraging, there
are a number of design problems which need to be discussed. One of these
problems relates to the population of students. The inequitable gender and age
distributions, is one such difficulty, others are the differences in the number
of sessions, and the varying lengths of the interventions. Running groups
across three different schools also introduces unknown variables which could possibly
confound the results. There are also the problems associated with using a model
rather than a manualised approach. However, useful data were collected from the
group members through the Group Session Evaluation at the end of each session,
which provided some validation that the intervention was compatible with the
group work goals established by Kelly’s (1991b) assumptions of personal
construct group psychotherapy. Data collections at Time 3 are not available to
provide further support for the effectiveness of the intervention. Finally, the
group work intervention has not been compared with other psychological
approaches. These design problems influence the power of the findings, the
generalisability of the results, and question their representativeness.
CLINICAL
IMPLICATIONS
Personal construct small-group work for
primary school students was developed to integrate the psychological needs of
the students, counsellor skills and expertise, and the criteria needed for
treatment research. The clinical implications are that the intervention was
able to meet some of the psychological needs of the students, and that the
skills and expertise of the group leader were useful and necessary. Over the
sessions, the participants increasingly felt they were a valued member of their
group, and that their group would always be there to support them. The clinical
implications of these experiences were that the participants found it was
‘safe’ to talk about their anger and anxieties, and that when they talked, they
felt ‘better.’ They also found that when this happened, they weren’t as easily
provoked into reacting to others with physical threats and violence. It also led
to the participants being able to express themselves more effectively and
appropriately, inside and outside their group. The clinical implications of
these group processes for group leaders, is the need to provide simultaneously,
support for each member, and for the group as a whole. While providing this
dual support, leaders also need to model reflexive listening, and provide
encouragement for members to experiment, and not ‘shy away’ from possible
changes in themselves, and from changes in the reactions of others to
themselves.
The clinical implications are also that
this intervention is able to go some way to meeting the criteria for
evidence-based practice, leading to improvements in social skills and
self-esteem by the members. The approach has been shown to be applicable and a
useful intervention in a school setting with primary school age students.
CONCLUSIONS
The research has shown that small-group
personal construct counselling is a useful and efficacious intervention, which
improves the psychological functioning of primary school students. It is also
an approach that can be undertaken in a school setting by the school counsellor.
Future investigations are needed to overcome some of the design problems in
this research, and to account for other factors which have been shown to
contribute to effective interventions, such as, counselling method (Nathan
& Gorman, 2002), the counsellor (Wampold, 2001), the counselling
relationship (Norcross, 2002), and the client, the students (Bohart &
Tallman, 1999). Future focused research and programme evaluation is needed to endorse evidence-based group interventions
with children. | |
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ABOUT THE
AUTHORS
Deborah Truneckova, PhD is an Honorary
Fellow, Illawarra Institute for Mental Health, University of Wollongong,
Australia, and a Doctor of Philosophy, Clinical Psychology. In collaboration
with Linda Viney, she has published a number of articles and presentations on
personal construct counselling, individual and group work interventions, and on
group and peer group supervision of psychotherapists. She is currently working
as a School Counsellor with the Department of School Education, New South Wales, Australia, and maintains a
passionate interest in the provision of effective psychological services to
children and adolescents, and their families. Email:
truneckej@hotkey.net.au
Linda Viney, PhD is Professorial Research
Fellow in Clinical Psychology at the University of Wollongong, having directed
the Clinical Postgraduate Program for 15 years. Linda has applied personal
construct psychology, and published in the areas of clinical, counselling and
health psychology, with 175 book chapters and articles with an emphasis on
processes and on evaluation. Recently she applied this approach, leading a
research project funded by the Australian Research Council with mental health
consumers to evaluate mental health services. This project received the Gold
Medal for the best Mental Health Research in Australia
and New Zealand
for 2004. Linda is currently collaborating in a book called Personal Construct
Methodology to be published by Wiley. Linda, in collaboration with Deborah
Truneckova, has developed models of individual and group supervision using
personal construct psychology. Email: lviney@uow.edu.au
Home Page: http://www.uow.edu.au/health/psyc/staff/UOW024981.html
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REFERENCE
Truneckova, D., Viney, L. L. (2008). Small-group counselling with primary school children. Personal
Construct Theory & Practice, 5, 139-148.
(Retrieved from http://www.pcp-net.org/journal/pctp08/truneckova08.html)
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Received: 24 September 2007 – Accepted: 28 May 2008 –
Published: 23 December 2008
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