Remedial Model or Social

Treatment Model

Also referred to as the “Michigan Approach”, or

“Psychotherapy groups,” developed by the group work
faculty of the University of Michigan headed by R. Vinter.
 Introduction
• Human beings are strongly dependent on
interactions with other humans.
• Social work practice with groups builds on
the important impact of groups on
individuals and utilizes group processes to
accomplish individual and group goals..
• Enhancement of social functioning through the
use of the group is the primary aim of group
work.
Social Group Models: The Remedial Model:
 Tends to be clinically oriented.
 Uses groups for treatment or
rehabilitation.
 Facilitates the interaction among members
of the group to achieve change for the
individual.
 The group supports the member,
encouraging new, more appropriate modes
of functioning.
 The Remedial Model:
Target Beneficiaries:
Those persons who are seen to be
headed toward the deviant paths (e.g.
out-of-school youth, street children,
drug users, etc.)
 Composed of members with severe
emotional, behavioral, and personal
problems (e.g. sexually and physically
abused, bullied kids, abusive parents,
etc.).
 The Remedial Model:
Target Beneficiaries:
 Also appropriate for those who need
help in the acquisition of new
knowledge and skills and the
development of new values and
attitudes to replace some dysfunctional
ones which may have become the
source of their difficulties (e.g. medical
patients, physically handicapped, low-income
persons, abusers, non-assertive wives, etc.).
 The Remedial Model:
Agencies or Institutions likely to
use this model:
This model can be useful to agencies
and institutions performing social
control functions (e.g. Youth Home for
CICL, correctional institutions,
rehabilitation centers, mental health
facilities).
 The Remedial Model:
 Leaders or Facilitators of these
groups must have excellent
counseling and group leadership
skills.
 Leaders or Facilitators develop and
maintain a constructive atmosphere
within a group.
The Interactional View of Deviance

o Problematic behavior is generated and

maintained through interactions between the
client and individuals and/or situations.
o Vinter calls this “an interactional view of
deviance,” (e.g. bullyer vs. bullied).
o The judgments and responses of others to a
“problematic behavior”, and the consequent
series of interactions between them and the
individual, tend to shape and sustain the
“problematic behavioral patterns.”
Extra Group Means of Influence

oThus, in this approach, those persons

and groups with whom the individual
concerned comes into frequent
contacts are also targets for
intervention.
oThey are termed as “extra group
means of influence.”
 Goal of Treatment Groups

o The goal of Treatment Groups is to

have members explore their
problems in depth and then develop
strategies for resolving them.
oTreatment approaches can be used to
change dysfunctional behaviors and
unwanted emotions of group
members.
 Goal of Treatment Groups
o The group is both “a means of
treatment and a context for treatment.”
o As a means, it serves as a vehicle
through which interactions and
influences are used to affect group
members.
o As a context, it provides opportunities
for interactions which can contribute to
change.
Objective of Remedial/Treatment
Groups
 The objective of Remedial Groups,
often referred to as Psychotherapy
groups, can be divided into 3
categories: (Levine, 1991)
1.) Supportive Treatment
2.) Interpersonal Growth
3.) Intrapsychic Growth
 Objective of Remedial/Treatment
Groups
1.) Supportive Treatment
Objectives - generally
emphasized restoration,
enhancement, or maintenance of
each member’s level and mode of
function or of problem-solving.
 Objective of Remedial/Treatment
Groups

2.) Interpersonal Growth

Objectives - focus on helping
members gain insight growth and
change in their relationships.
 Objective of Remedial/Treatment
Groups
3.) Intrapsychic Growth
Objectives - emphasizes
insight development,
which serves as the base
for growth and change.
 Sample Case

o Group work with Sexually Abused

Children
o (Advantage of group treatment vs. one-on-
one therapy: the “helper therapy” principle is
operative. Members interchange roles and
become the “helper” for someone else,
receiving psychological rewards and putting
their own problems into perspective in the
process).
 Treatment Sequence
o Treatment sequence in this model
involves the same basic steps in the
generic social work helping process:
o A. Assessment (Study & Definition of the
Problem)
o B. Planning
o C. Implementation of Plans
o D. Evaluation
o E. Termination
 I. Preparation and Homework
o Extensive preparation is needed for
leading a treatment group.
o Leader or Facilitator should have
considerable training in: assessing human
behavior, therapeutic approaches,
therapeutic intervention techniques,
interviewing and counseling, principles of
group dynamics.
 In planning for a new group, the following
questions need to be formulated:
o What are the overall purpose and general
goals of the group?
o What are the ways in which these general
goals might be accomplished?
o What are the characteristics of the members?
o What are the unique and individual needs of
each member?
o What resources do the members need in
order to help them better handle their
personal problems?
 In planning for a new group, the
following questions need to be
formulated:
o What are the individual therapeutic goals
for each member?
o What type of group atmosphere will best
help the members solve their personal
problems?
o What do the members expect you to do?
o What should be the formal of the first
meeting?
 Planning the Treatment Groupwork
Program for Sexually-Abused Children
(TAU)
o The purpose for this program will be to:
1.) Provide the children with an
opportunity to express their thoughts and
feelings about the abuse in a safe and
accepting environment.
2.) Help the children overcome their
feelings of isolation, guilt, betrayal,
powerlessness, and shame.
 Planning the Treatment Groupwork
Program for Sexually-Abused Children

o The purpose for this program will be to:

3.) Help the children develop skills in
setting physical and emotional boundaries
in order to prevent re-molestation.
4.) Help the children learn about normal
sexual development; and
5.) Help the children develop self-esteem.
 The Group “Program Package”

o The group worker will conduct weekly

group sessions, for one-and-a-half to two
hours over a period of three months.
o Use of “Group Therapy Module” –
consisting of structured activities for
eleven sessions, with a theme for every
session.
The Group Therapy Module:
 Session 1: Getting started, orientation,
and goal-setting
 Session 2: Discussing terms used in
dealing with sexual abuse
 Session 3: Sharing and remembering
 Session 4: Sharing and remembering
 Sessions 5: Naming, sorting,
understanding and expressing feelings
The Group Therapy Module:
 Session 6: Developing self-esteem (The
Positive Box and
 Session 7: Building a Constructive Body Image)
 Session 8: Guilt and Responsibility
 Session 9: Understanding the physical changes
during puberty
 Session 10: Teaching boundaries/ Abuse
prevention skills
 Session 11: Setting personal contracts and
evaluations.
 Intake, Group Composition and
Formation
 Group worker reviews the individual
records of the girls who are referred to
her by the caseworker for group
membership.
 The groupworker has the final say about
group composition based on criteria set
by the agency (e.g. age, sexually
abused, period of months, not under
psychiatric care).
 Initial Group Sessions
o Giving self-introductions; expectations.
o Say anything what they wanted to say.
o Assure the group that it was alright to
have negative feelings.
o Orientation – general idea of what they
will be doing during the sessions.
o Clarify roles – Facilitator,“helper therapy”
o Rules to guide conduct – agreed by all.
o Explain “confidentiality”
 Succeeding sessions
o Building rapport
o Non-threatening group atmosphere
o Using tact in treatment groups
o View group members as equals
o Use shared vocabulary with them
o Keep confidentiality
o “What is said in the group, remains in the
group.”
 Throughout the sessions
oRemind about rules, confidentiality,
expressing feelings.
oProcess feelings, lessons learned.
oExplore problems in depth.
oExploring alternative solutions.
oWrite contract for future reference
oReward when they meet
commitments.
 Contract Outline
o Goals
o Tasks
o Time Frame
o Means
o Rewards if terms of contract are met
o Adverse consequences upon non-
fulfillment of the terms of contract
 Evaluation and Termination
o Review of group goals.
o What are the learning.
o How they had been helped through their
experience in the group.
o Sharing of insights and plans.
o “Positive strokes” to one another.
o Sharing of promises, resolutions.
o “Bright future” – follow-up by
caseworker
 Evaluation Forms for Treatment
Groups
o Use the following scale: (1) Strongly
Disagree; (2) Disagree; (3) Neutral or
Uncertain; (4) Agree; (5) Strongly Agree
1. I am satisfied with what this group has
accomplished.
2. My personal goals in this group have
been attained.
3. I truly enjoyed being a member of this
group.
 Evaluation Forms for Treatment
Groups
4. The facilitator has done a superb job in
leading the group.
5. This has been one of the most
rewarding groups I have participated in.
6. I have grown extensively as a person
through participating in this group.
7. I have made substantial progress in
resolving those personal problems that
led me to join this group.
 Evaluation Forms for Treatment
Groups
(The next 3 questions are open-ended):
8. The strengths of this groups are:
_______________________________.
9. The shortcomings of this group are:
_______________________________.
10. My suggestions for changes in this
group are:
_______________________________.
 The Therapeutic Factors
oWhat is it that Heals?
oThat lead to positive changes
in clients who receive group
treatment?
 The Therapeutic Factors
oAlbert Ellis (Rational-Emotive
Therapy)
oWhat heals is the change from
a negative self-talk or
irrational thinking to a more
rational and positive self-talk
or thinking.
 The Therapeutic Factors
Dr. Irvin Yalom (prominent group therapist)
listed 12 factors:
1. Instillation of hope - members are
inspired by other group members who
have trod the same path and then
improved their lives.
2. Universality - others have similar
problems and have made progress.
 The Therapeutic Factors
3. Impacting Information - they receive
useful information from others.
4. Altruism – the “helper therapy”
principle.
5. Corrective recapitulation of the
primary family group - members gain
better understanding of traumatic
family experiences.
 The Therapeutic Factors
6. Development of socializing techniques
- provide opportunities to try out more
functional behaviors.
7. Imitative behavior – model
constructive behavior
8. Catharsis – opportunity to ventilate
9. Existential factors – find meaning to
life.
 The Therapeutic Factors
10. Group Cohesiveness - experience
trust, warmth, empathic
understanding, acceptance.
11. Interpersonal Learning - experience
communication, trusting, honesty,
loving
12. The group as a Social Microcosm - of
the world they live in.
 Essence of the Remedial or
Treatment Model

 In essence, a remedial group

therapist uses the principles
of one-to-one counseling
and of group dynamics to
help clients change
dysfunctional attitudes and
behavior.
 Essence of the Remedial or
Treatment Model

 Often, the traditional

psychotherapy approaches are
combined with specialized
treatment techniques (e.g.
parent effectiveness training,
assertiveness training), to help
clients resolve personal and
emotional problems.
 References
o Mendoza, Thelma-Lee (1999). Social Work
with Groups. Megabooks Co. Q.C.
o Reid, Kenneth E. (1997). Social Work Practice
with Groups: A Clinical Perspective.
Brooks/Cole Publishing, USA
o Zastrow, Charles H. (2004). Introduction to
Social Work & Social Welfare: Empowering
People. Thomson Brooks/Cole, USA.
o Zastrow, Charles H. (2006). Social Work with
Groups: A Comprehensive Workbook.
Thomson Brooks/Cole, USA.
Garland, Jones, and Kolodny Model
of Group Development
o Another useful Model of Stages of Group
Development for Treatment groups is the
Garland, Jones, and Kolodny Model:
o A. Pre-Affiliation
o B. Power and Control
o C. Intimacy
o D. Differentiation
o E. Separation
 A. Pre-Affiliation stage

o Interaction is guarded; attempt to

protect themselves from being hurt;
maintaining certain distance.
o Facilitator seeks to make the group as
attractive as possible.
o Use ice-breaker; invite trust
o Make them feel safe and comfortable.
o Indicate the benefits of continuing on
with the group
 B. Power and Control

o Character of the group emerges

o Alliances, patterns of communication,
subgroups
o Power struggles - normalize
o Give emotional support
o Problem-solve the issues emerging
o Assist in establishing norms
o Develop trust and maintain balance of
shared power and control
 C. Intimacy

o Group becomes more like a family

o Likes and dislikes expressed
o More open to express and discuss
feelings
o Members feel free
o Feelings of cohesiveness and “oneness”
o Members realize “what this group is all
about.”
 D. Differentiation

o Exploring new and alternative behavior

patterns.
o They communicate effectively.
o Have reached “maturity” – now ready to
pursue their own lives.
o Relationships are equal; members are
mutually supportive and able to relate
“maturely”.
 E. Separation

o Bittersweet experience
o Goals have been achieved
o Members have learned new behavior
patterns that are more functional for
them
o Able to express “letting go.”
o Help identify resources
o Assist in recognizing strengths and
capacities to handle future challenges.
 Ending a Session
o Accept the fact
o Subjects/topics discussed are not “left
hanging”
o Initiate preparations for ending – give
assignments, summarize
o Relaxation exercises.
 Ending a Group
o This may produce a variety of emotions
o Kubler-Ross’ Stages of Grieving - Denial,
Anger, Bargaining, Depression,
Acceptance
o Summarize the emotional reactions
o Obtain feedback;
o Evaluation