Disclaimer: This dissertation has been written by a student and is not an example of our professional work, which you can see examples of here.

Any opinions, findings, conclusions, or recommendations expressed in this dissertation are those of the authors and do not necessarily reflect the views of UKDiss.com.

Domestic Violence (DW) Survivor Awareness Program

Info: 8774 words (35 pages) Dissertation
Published: 9th Dec 2019

Reference this

Tagged: CriminologyHealthPsychology


This program is designed to bring awareness to domestic violence (DV) survivors.  This group will promote physical and emotional health of victims of a violent relationship.


The population of this group is developed for divorced women above the age of 18, who have been victims of domestic violence.  A divorce is stressful.  Going through a divorce that brings emotional, financial, or even physical abuse can be devastating.  The goal is to empower women through female leadership and through women who have had similar experiences.


Domestic violence is a serious public health problem.  In the United States a woman is abused or beaten every 9 seconds (NCADV, 2018).  At least 1 in 3 women have been domestically abused by an intimate partner, and 1 in 5 of those incidences were drastically violent (NCAVDV, 2018).  Research shows 25-40 percent of women who initiate divorce do so because of domestic abuse (Brygger, 1990).  Domestic abuse is the use of physical, emotional, financial, or mental abuse to gain control in an intimate relationship (Moncrieff, 2018).  This results in fear, emotional, and physical suffering for the victim.  Domestic abuse can take many forms from assault, forced sexual acts, threatening violence, psychological abuse, gas lighting, stalking, financial control, isolation, and degradation (Zakaliyat & Susuman, 2018).  These acts are used to gain control of another that can be long-lasting torment for the victim.

Numerous abuse victims do not know or think of themselves as being abused.  This is because many times the abuse is overlooked, denied, or excused.  This happens when the abuse is psychological.  A cycle of domestic violence ensues because the victim does not know what to do to end it.  This cycle has three phases: tension building, abusive incident, and honeymoon phase (Davis, 2017).  Tension building is when the victim feels as if they are “walking around on eggshells” around the abuser.  Eventually something will happen that will break the tension and cause an abusive incident.  The abusive incident is when the abuser lashes out at the victim, whether physically or emotionally.  The final phase is the honeymoon phase.  This happens when the abuser tries to apologize to the victim or “make it up to them” by buying expensive gifts, promising to stop the abuse, and/or promising to change.  Once the honeymoon phase is over, the cycle will restart.  The abuse continues in a never ending cycle.

Ending a marriage can be upsetting.  Ending a marriage because of domestic abuse is even more detrimental.  Women who have been controlled, especially through financial containment have a hard time leaving the relationship (Gibbs, Dunkle, & Jewkes, 2018).  It is hard for the victim to start over when the finances in the household have been controlled, or if the victim is not allowed to work.  Adding physical, emotional, or mental abuse on top of that can make the victim feel as if they will never escape.

It is important for these abused victims to know that they are not alone.  Research has shown, women that share their own experiences of abuse can empower them and others (Dann, 2018).  Through a domestic violence support group, these women have a chance to turn their negative experiences into something positive.  Many times a domestic violence victim can relate better to another victim than turning to a family member who has never experienced domestic violence (Xia, Li, & Liu, 2018).  Change happens when victims can get together with other survivors and share their experiences and provide support to one another.

Group therapy is beneficial for survivors because it allows them to connect with others who have been through similar experiences.  In order for survivors to change, being aware of their self-worth is essential (Hogue, 2018).  Connecting with others with the same issues can reduce the feelings of self-doubt and isolation that was created by the abusers.  Overcoming a traumatic experience can be scary for anyone.  Being able to share experiences and connect with others in a group can help survivors regulate their own emotions and decision making skills.

Individual and group therapy can have amazing benefits to survivors of domestic violence.  When researching which type of modality is best, it is important that the therapeutic format be adapted for the survivor’s specific needs (Echeburua, Sarasua, & Zubizzarreta, 2013).  A survivor may not want to share her experiences with a group because it will make her feel worse about her situation and about herself.  Therefore, an individual setting would be more appropriate.  Group therapy has better social support by group members that have experienced similar situations.  Members can provide enhanced motivation for change and a better learning environment for coping skills because others are learning as well (Echeburua, Sarasua, & Zubizzarreta, 2013).

Theoretical Approach

In this program there are three approaches that will be used.  The three approaches used will be Existential Therapy, Cognitive Therapy (CT), and Solution focused Brief Therapy (SFBT).  Through these approaches, the group leader will help the members develop behavioral alternatives to work through.  There are five mental phases that victims go through when coping with such a traumatic experience.  These five phases are shock/denial, bargaining (they try to reason with the perpetrator), anger, depression/awareness, and acceptance (Foreman & Frederick, 1984).  To reach each of these stages, the group leader will emphasis treatment plans and goals to increase self-disclosures, personal responsibility, and safety plans.

Existential Therapy places emphasis on an individual’s choices that he/she makes (Day, 2009).  Even though environmental factors do create obstacles, existential therapy holds that people are the authors of their own lives.  This is an important aspect for a domestic violence survivor.  This approach helps the victims see that they are in control of their own lives and are responsible for the choices they make.  As a DV victim, most have led restricted lives and have not seen or thought of alternatives for dealing with the violence.  This can make the victim feel helpless and trapped.  A group experience will help the members see these patterns and examine ways to change the outcome for the future.

According to Corey (2018), “There are six key propositions of existential therapy: (1) Capacity of self-awareness. (2) Since we are free beings, we must accept responsibility that accompanies our freedom. (3) We have a concern to preserve our uniqueness and come to know ourselves in relation to knowing and interacting with others. (4) The significance and meaning of life are never fixed once and for all, we just recreate ourselves. (5) Anxiety is part of the human condition. (6) Death is a human condition, the reality of our mortality heightens our sense of ultimate aloneness (p 118).”  The ultimate goal of existential therapy is to lead the members in acquiring and identifying the freedom they have in their own lives.  The group leader will emphasis member responsibility and their freedom of choice.

Cognitive Therapy (CT) is a type of psychotherapy that challenges faulty thinking and incorrect information that stems between fantasy and reality (Iverson, Gradus, Resick, Suvak, Smith, & Monson, 2011).  This is an important approach to use with DV survivors because it helps the victims unlearn self-defeating thoughts that have been brought upon them by the abusers.  The group leader will help the members recognize these negative thoughts and rectify them so that the individual can have a more satisfying life.

During this approach, the group leader will assist members in collaborative empiricism and cognitive restructuring.  Collaborative empiricism happens when the group leader works with members to analyze the evidence for numerous beliefs and considers more adaptive ways of thinking.  Members will learn that their thoughts have substantial influence on their feelings and behaviors and how it impacts their reality.  Cognitive restructuring will aid members in detecting times when their thoughts are fixed on the most negative features of a situation.  Members will learn to listen to self-talk and acquire new coping skills essential for behavioral transformations (Corey, Corey, & Corey, 2018).

Solution Focused Brief Therapy (SFBT), is a development from talking about problems to creating solutions to those problems.  There are four themes that members will go through during this approach.  They are emotional regulation, person development, reconstructing family relationships, and improving communication (Bolton, Lehmann, Jordan, Frank, & Moore, 2016). Members will gain insight to these themes and how they work.  This will help DV survivors accept change in small ways so that larger changes can happen.  It will help members create their own goals and prepare for a better future.

The group leader will use different techniques in SFBT including exception questions, miracle questions, etc.  These types of techniques are used to focus on client strengths, unused resources, and help clients come up with solutions that work (Corey, Corey, & Corey, 2018).  SFBT is about working collaboratively with the client rather than conducting therapy on the client.  This allows a more therapeutic and collaborative partnership.


“Getting the word out” about a counseling group can be financially taxing.  However, it will raise awareness about the group and the services provided.  The place to start would be within the community.  Direct mail, billboards, flyers, and radio ads are just a few things to get information out in the community about the group.   Explaining the services offered, prices, and even using coupons can be a power tool in recruiting members.  Another place to look would be at other counseling centers.  Let the centers know the group you are putting together and have them refer clients to the group that they believe would benefit from it.  Networking with women’s shelters and organizations locally and nationally is another avenue to spread the word about the group.  The group leader should also make the national domestic hotlines aware of the group so that they may refer clients in that area.


During the screening process, the group leader will use a Domestic Violence Intake form (See Appendix One).  This form will give the group leader the necessary information about the individual that is needed to start treatment if they are a candidate.  The intake form gives information about age, marital status, current living situation, who the abuser was in connection to them, what type of abuse the member was put through, the last incident that happened, and the type of services the member(s) are looking for.  The group leader will then select members that are over the age of 18 and divorced that have been a victim of domestic abuse.


This group will be held on Tuesday evenings from 5pm to 6pm.  There will be a total of 11 sessions, each session having its own topic.  The size of the group will be no less than 5 and no more than 8 participants and will meet at the local community building.  With larger groups there is more of a chance for facilitator burnout, less personalization, and less opportunity to achieve best outcomes (Cohen & Rice, 1985).  With groups less than 5 members it generally ceases to operate because of less member interactions and the therapist doing most of the work.

Pre and Post Group Meetings

Every Tuesday for 11 sessions between 5pm-6pm the group will follow the topic of the evening.  There will be a post group meeting as a follow-up with the members to assess outcomes.  During this session group members can share problems that they have had and work through any thoughts or feelings with each other.  This gives members an opportunity to look back over what they have learned and to see if they are applying it in everyday life.  It will also give the members the opportunity to talk about their support networks after the group has ended and whether or not their network is working for them.


The goal of this domestic violence group is to help the members recover from the traumatic experience of abuse.  Ensuring a supportive community, enhancing networking for members, developing a safety plan, and how to cope through the abuse are goals that will be covered throughout the DV counseling group.

Group Rules

In the beginning of the group it is important that the group leader explain group rules.  Some group rules that will be included are: give everyone an opportunity to speak, be honest, respect one another, what happens in group stays in group, do not interrupt, openly communicate, use kind words, respect privacy, arrive on time, and have good listening. These rules will give the group guidelines so that there is cohesive flow throughout the session.

Ethical Issues

It is important that the group leader consider any ethical issues that may arise in group counseling.  Referring clients, clients and sharing, group leader’s roles, and client self-disclosure are all ethical issues to be considered in group counseling (Corey, Williams, & Moline, 1995).  The group leader will need to be mindful if/when a client needs to move onto someone more experienced, or to an individual counseling setting.  Clients should be able to share as much as they want, as long as it is applicable to the topic.  Clients should know they do not have to share anything that makes them uncomfortable.  The group leader needs to be competent and knowledgeable about DV counseling.  Client self-disclosure should be addressed in the beginning of the group session.  Members need to be aware of the harm it could do breaking confidentiality.  Members will sign an informed consent for this as well (See Appendix Three).

Multicultural Issues

In a diverse group it is important to address any multicultural issues that may arise.  Understand that members that come from a marginalized group more than likely have experienced racism or discrimination and are often apprehensive with their participation.  The group leader needs to be aware of their own values, biases, and personal beliefs, have knowledge of the diverse members in the group, and able to apply theoretical approaches that suit the diversity amidst the group (Corey, Corey, & Corey, 2018).  Multicultural issues should be addressed head-on.  The group leader should be able to discuss with the group his/her own shortcomings and how his/her worldview impacts his/her beliefs and processes.  In this type of group there could be multiple multicultural issues.  There could be differences in culture, race, beliefs, and even health related issues because of the abuse.  Being sensitive to these issues and having open communication will help members open up about these delicate issues.

Group Leadership

The role of the group leader is to promote a cohesive group experience and encourage empowerment and self-help among the group members.  It is important the group leader create a warm and accepting environment and emphasis group growth and change.  A master’s degree in counseling and knowledge in domestic abuse are necessary when counseling domestic violence survivors.

Risks and Benefits

When dealing with trauma there can be risks and benefits.  Group counseling can bring positive change to members.  However, it is the leader’s responsibility to protect clients from possible psychological, physical, or emotional trauma that the sessions could open up (American Counseling Association, 2014).  The members in a domestic violence group will be going through a lot of changes.  Their life, routine, home life, children’s lives are all changing dramatically.  It is the leader’s responsibility to be aware of any problems that may grow out of the group experience (Corey, Corey, & Corey, 2018).  Leaders should also be aware of the impact that they may have on the group members and not to abuse their power.


After particular sessions, the group leader will hand out evaluation forms for the members to complete.  There is a copy of the form (See Appendix Four).  This will allow the group leader to know what is working and what needs improvement.  It will also give the group leader a chance to know what is working for each individual group member and what is not.

Group Sessions

  1. Session One: Fundamental Rights.

During this session the group leader will greet the members and create a safe and welcoming environment.  The group leader will bring everyone to sit in a circle and will start off by meeting all the members and learn a little bit about each individual.  The members will be given an overview on what to expect from the upcoming meetings and an understanding of what each group member expects to gain from the group.  Then the members will sign a group contract and client consent form after going over what their basic rights are and the group rules (See Appendix Two and Three).  Important information such as the emergency exits, bathroom, access issues, childcare, and smoking policies will be covered.  There will be an overview on each session and what will be discussed in future sessions.  Then the group will do an exercise.  The exercise will consist of each group member giving a statement with “I feel”.  This will open up a conversation on how they feel about life, the group, work, etc.  The group will end with the group leader congratulating everyone for completing the first session and encouraging the members to come back for session two.

  1. Session Two: What is Abuse?

This session will cover the definitions of abuse.  The session will start off with introductions so that the members may get to know each other a little more.  The group leader will use an ice breaker exercise.  This exercise requires the members to sit in a circle and toss a small ball back and forth.  When the members catch the ball they have to say their name and one fun fact about themselves.  The game stops once each member has had a turn.  The group leader will start the session by giving an overview of the previous session and asking each member what they believe abuse is and write them on board for all to see.  The leader will then hand out Appendix Four which is a control and power wheel.  Then the members will discuss the wheel and how each behavior is linked to power and control.  The members will discuss differences between financial, physical, sexual, and emotional abuse.  The end of the session will be left open for any questions the members may have regarding the session.  The group leader will thank the members for coming to session two and ask them to complete an evaluation form (Appendix Five).

  1. Session Three: Hard to Leave

This session will cover the many reasons why women find it hard to leave an abusive relationship.  This session will start with going over the previous session and taking a look at the power wheel again.  Then the group leader will write on the board, “Why is it hard to leave?” This will get the members talking and giving examples, which will also be written on the board.  Then the group leader will hand out the Cycle of Violence Wheel (Appendix Six).  The members will discuss the cycle of violence and then ask each member for some examples of abusive behavior.  At the end of the session the group leader will ask the members if they have any questions and thank them for coming to another session.  The members will be asked to complete another evaluation form (Appendix Five).

  1. Session Four: Divorce and Children

This session will cover past childhood connections and why members have a hard time having healthy adult relationships.  It will also take a look at how domestic abuse affects children (if the members have children). The session will start with a recap of the previous session and then the group leader will split the members into two groups.  Each group will have two topics and will write down examples of behaviors and situations that may occur.  The first group will be assigned Functional Family and Needs of Children.  The second group will be assigned Dysfunctional Family and Effects of Abuse on Children.  Once the groups are finished, the group leader will go over the lists and have the members discuss or add more that may have been forgotten.  The end of the session should be left open for any questions that the members may have.  The group leader should encourage the members to take care of themselves, because that is the best way to support their children.

  1. Session Five: Boundaries

This session will take a look at boundaries and the importance of them.  The session will begin by recapping the previous session.  The group leader will then start the session off with giving the members a worksheet about boundaries (See Appendix Seven).  After completing the worksheet the leader will ask the members to share some of their boundaries and to give examples or situations on setting boundaries.  Control may be brought up as the members learn to set and gain boundaries for themselves.  The end of the session will be left open for questions and thanking the women for completing session five.

  1. Session Six: Coping with Fear, Grief, and Guilt

This session will focus on how members cope with the fear, grief, and guilt.  The session will start with a recap of the previous session.  The group leader will then discuss the feelings of fear, grief, sorrow, pain, etc. that are experienced in an abusive relationship.  The group leader will ask the group to give some feelings so that they can be written on the chart.  This will show the women that they are not alone in their feelings.  In the middle of the session, the leader will move from guilt to responsibility.  The leader will hand out the Shame Cycle (Appendix Eight). The leader will ask how to move from shame to a more positive cycle and how this cycle is connected to self-esteem.  The end of the session will be left open for questions and the leader will thank the group for being more than halfway through the sessions.  The group leader will ask the members to fill out an evaluation form (Appendix Five).

  1. Session Seven: Coping with anger

This session will cover how members deal and cope with anger associated with the trauma they have encountered.  The session will start with a recap of the previous session.  Then the group leader will go over the feeling of anger and what situations have made the group members feel anger.  The group will be asked to think of positive situations that involve anger and how anger has contributed to those situations.  These situations will be written on the board and shown how anger can be channeled into something good.  At the end of the session the group leader will ask the members if they have any questions and thank them for attending another session.

  1. Session 8: Assertiveness Skills

This session will cover why women find it hard to be assertive.  The session will start with a recap of the previous session and what the members think when they hear the word assertiveness.  These will be written on the board.  The group leader will hand out an assertiveness chart (Appendix Nine).  Then the leader will ask the members to give an example of each passive, aggressive, and assertive situation they have encountered.  The end of the session will be open to any questions and the leader thanking the members for finishing session eight.  The leader will also ask the members to fill out another evaluation form (Appendix Four).

  1. Session 9: Legal Issues

In a domestic violence situation, there are bound to be some legal issues along the way.  This session will cover why it is difficult to make and refuse requests, seek legal help, and why authority figures are precarious to survivors.  The session will start with a recap of the previous session and asking the members how difficult it is for them to make and refuse requests.  These requests will be written on the board.  Then the members will discuss why making requests is so hard by discussing fear of rejection, low self-worth, need to be in control, and fear of using others.  Then the group leader will go over helpful tips for saying “NO.”  The end of the session will be left over for questions and a list of resources will be given to each member that contains legal aid information, women’s shelters, and domestic violence petition information.  The session will end with the group leader thanking the members for coming and commending them on all the hard work they have completed while in the group.  The leader will also remind the members that the sessions are coming to an end so that the members will be ready for termination.

  1. Session 10: Healthy Relationships

In this session the group will talk about the differences between unhealthy and healthy relationships, unrealistic expectations, and stereotypical images of romantic love.  The session will start off with a recap of the previous session and an exercise on love.  The leader will ask the members to define true love and will write the answers on the board.  The leader will hand out the Equalities Wheel (Appendix Ten).  The leader will encourage the group to discuss different qualities of an equal relationship.  At the end of the session the group leader will leave room for questions and remind the group that there is one session left before termination.

  1. Session 11: Termination and New Beginnings

The final session has arrived.  The leader will recap everything that has been learned in the course and how far the members have come.  It is a time to celebrate successes and anticipate the new beginnings that are about to come.  In this session it is important to stress how much the members have achieved.  It would be a good time to ask each member what they have learned from the course and what they believe their strengths are.  Write these strengths on small poster board so that the members may take it home with them as a reminder of how strong they are.  At the end of the session leave time for any questions the members may have.  The leader may need to stay after the session to answer any questions or give networking advice for the members that want to continue counseling (whether individual or group), community resources, etc.  Let the group members fill out the final evaluation form (Appendix Four), and say goodbye.


American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author

Augustine, O. D., & Idowu, A. P. (2016). Women and domestic violence: Implication for counseling. Ife Psychologia, 24(2), 195.

Bolton, K. W., Lehmann, P., Jordan, C., Frank, L., & Moore, B. (2016). Self-determined goals in a solution-focused batterer intervention program: Application for building client strengths and solutions. Journal of Human Behavior in the Social Environment, 26(6), 541-548. doi:10.1080/10911359.2016.1172996

Brygger, M., (1990). Family Advocate. Domestic Violence: The Dark Side of Divorce, 13(1), 48- 51.

Cohen, S., Rice, C., (1985). Maximizing The Therapeutic Effectiveness of Small Psychotherapy Groups. Group, 9, 3-9

Corey, G., Williams, G. T., & Moline, M. E. (1995). Ethical and legal issues in group counseling. Ethics & Behavior, 5(2), 161-183. doi:10.1207/s15327019eb0502_4

Corey, M., Corey, G., Corey, C. (2018). Groups: Processes and practice (10th ed.). Boston, MA: Cengage Learning.

DANN, S. (2018, ). Supporting victims of domestic violence: SBC international Women’s day event. Singleton Argus

Davis, N. (2017, ). Helping those in a cycle of domestic violence. TCA Regional News

Day, K. W. (2009). Violence survivors with posttraumatic stress disorder: Treatment by integrating existential and narrative therapies. Adultspan Journal, 8(2), 81-91. doi:10.1002/j.2161-0029.2009.tb00061.x

Echeburua, E., Sarasua, B., Zubizarreta I., (2013). Individual Versus Individual and Group Therapy Regarding a Cognitive-Behavioral Treatment for Battered Women in a Community Setting. Journal of Interpersonal Violence, 29(10), 1783-1801

Foreman, R., & Frederick, M. (1984). Domestic violence: A training manual for mental health professionals. Saratoga, Calif: R&E Publishers.

Gibbs, A., Dunkle, K., & Jewkes, R. (2018). Emotional and economic intimate partner violence as key drivers of depression and suicidal ideation: A cross-sectional study among young women in informal settlements in south africa. PloS One, 13(4), e0194885. doi:10.1371/journal.pone.0194885

Hogue, J. (2018). Developing an integrative group treatment program for adult female survivors  of domestic violence incorporating narrative therapy and acceptance commitment therapy

Iverson, K. M., Gradus, J. L., Resick, P. A., Suvak, M. K., Smith, K. F., & Monson, C. M. (2011). Cognitive-behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors. Journal of Consulting and Clinical Psychology, 79(2), 193-202. doi:10.1037/a0022512

Moncrieff, G. (2018). The cyclical and intergenerational effects of perinatal domestic abuse and mental health. British Journal of Midwifery, 26(2), 85-93. doi:10.12968/bjom.2018.26.2.85

NCADV., Statistics. (n.d.). Retrieved October, 2018. from  https://www.thehotline.org/resources/statistics/

Pope-Davis, D. B., Coleman, H. L. K., & Liu, W. M. (2003). Handbook of multicultural competencies in counseling and psychology. US: Sage Publications Inc.

Xia, Y., Li, S. D., & Liu, T. (2018). The interrelationship between family violence, adolescent violence, and adolescent violent victimization: An application and extension of the cultural spillover theory in china. International Journal of Environmental Research and Public Health, 15(2), 371. doi:10.3390/ijerph15020371

Zakaliyat, B., & Susuman, A. S. (2018). Factors of domestic violence against women: Correlation of women’s rights and vulnerability. Journal of Asian and African Studies, 53(2), 285.


Appendix One

Domestic Violence Intake Questionnaire


Your Name ___________________________________________________________________

[   ] Female  [   ] Male

Birth Date ___________________

Are you under 18 years of age? [   ] yes [   ] no

Petitioner’s Place of Birth ______________

Race [   ] Black [  ] White        Ethnic Origin ______________________

Address:  ____________________________________ City __________________ State ______

Zip Code _________

Tel. No. (       )____ – ____ Alternate No.(       )____ – _____

Employer _____________________________________________________________________________________

Employer’s address _______________________________________________________________________________

Telephone Number (       ) __________ – ____________   Ext ________

What is your relationship to the person who brought you to see Domestic Violence Counseling?

[  ] Married    [   ] Divorced     [   ] Dating, if yes, how long? ______________

[   ] Roommate

[  ] Boyfriend    [   ] Former Boyfriend  [   ] Intimate Partner

[   ] Neighbor

[  ] Girlfriend   [   ] Former Girlfriend   [   ] Other, please specify: _________________

Do you or have you ever lived with the person you are filing against? [   ] yes [   ] no

Are you currently living with the person you are filing against? [   ] yes [   ] no

If yes, do you have an alternative place to stay tonight? [   ] yes [   ] no

Are you a victim of:

[   ] verbal abuse

[   ] psychological abuse

[   ] sexual abuse

[   ] physical abuse

[   ] stalking

The last episode of abuse took place:

[  ] This week   [   ] Last week   [   ] A month ago    [  ] Three months ago

[  ] Six months ago  [   ] One year ago  [   ] More than one year ago [  ] other ________________

Specific Date of the last incident: ___________________________

Briefly describe the last incident of physical abuse, sexual abuse or stalking:








 Briefly describe any specific area in which you need service.





Appendix Two

Group Agreements

Confidentiality agreement: You have the right to confidentiality and privacy by the group leaders and other group members. Confidentiality within the group setting is a shared responsibility of all members and leaders. While group leaders may not disclose any client communications or information except as provided by law, group members’ communications are not protected. As such, confidentiality within the group setting is often based on mutual trust and respect.

CAPS adheres to professional, legal, and ethical guidelines of confidentiality established by professional organizations and state law. Legal and ethical exceptions to confidentiality include: a clear or present danger to harm yourself or another, knowledge of the abuse or neglect of a minor child or incapacitated adult, or responses to a court subpoena or as otherwise required by law.

As a member of this group, I agree to not disclose to anyone outside the group any information that may help to identify another group member. This includes, but is not limited to, names, physical descriptions, biological information, and specifics to the content of interactions with other group members.

Additional group agreements:

  • I agree to come each week, stay the entire session, and to be punctual. Group will start and end on time.
  •  I agree that if I am going to miss a session I will let the group members and/or leaders know in a timely fashion.
  •  I understand that a minimum commitment of 3 sessions is required.
  •  I understand that it is my responsibility to discuss my therapeutic goals and reason(s) for attending. Also, I understand that no one is going to force me to talk or reveal difficult material before I am ready to do so.
  •  I understand that any form of physical contact is not permitted within the group setting.
  • I agree that as long as I am a group member, I will not subgroup with other members outside of group time (e.g. hang out, date)
  •  I understand that drinks are allowed, but food may not be.
  •  I agree that all cell phones will be turned off during group time.
  •  I understand that group sessions may be videotaped for training and supervision purposes. They will not become a part of my clinical record. These recordings are for the counseling center internal use only.
  •  I understand that during post-processing all members are encouraged to stay and listen. I agree to be silent during this time and if I have any reactions or comments about the post-processing, I will bring them back to the next group session.
  •  I agree to participate in group sober and not under the influence of controlled substances.
  •  I agree to stay in group until I have met my therapeutic goals. I agree that when I decide that I have gained as much as possible from group at this time, I will notify the group in advance of my intentions and come to group to say good-bye.
  •  I understand that the work of any unlicensed staff is supervised by a licensed senior staff member.
  •  I understand that any group outcome measures or satisfaction surveys are reported in summary form with no individual identifying information.  This information can assist the counseling center in improving services and in evaluating programs.

Consent to Record Group sessions: I authorize CAPS to videotape the group sessions. I understand the videotapes will be used for: quality assurance and supervision in accordance with accepted professional standards for psychologists and counselors. I further understand that: the tapes will be kept strictly confidential, that I may revoke my permission/consent at any time (with any applicable tapes being erased at that time), that all my questions have been answered by a counselor and that this consent is given voluntarily.

By my signature below, I indicate that I have read carefully and understand the Group Agreements and that I agree to its terms and conditions. I have asked and had answered any questions I have concerning these Group Agreements and am aware that signing the Agreement is required for my admission to the group. I am also aware that my refusal to sign this Agreement will exclude me from participating in the group.

Client Signature_____________________________________ Date ________________

Counselor Signature_________________________________  Date__________________

Appendix Three

Client Consent Form

The success of group therapy depends upon a high degree of trust between you, your group facilitator, and fellow group members. This document has been prepared to fully inform you about what to expect from group therapy and from your group facilitators.

Understanding Group Therapy

Group therapy is a process of understanding more about yourself and others in a safe environment. In group you will have the opportunity to explore patterns of thinking and behaving that are similar to how you relate to others in your life. Objectives of group therapy include, but are not limited to:

❖ Develop skills to assist you in reaching your goals

❖ Feel a sense of support from other group members

❖ Understand more about yourself and your family system

❖ Identify and explore thoughts, feelings and behaviors that hold you back

❖ Learn how to improve relationships with others

You are welcome to share as much or as little about yourself while in the group, however, the more open you are the better experience you will have. You are welcome to ask questions at any time. The more deeply you understand the process of therapy, the more effectively you will be able to incorporate positive change into your life.

The role of your group facilitators

Our philosophy and approach to group therapy is the belief that this is your group. Each group member will have an equal say in what topics will be discussed, and what format feels most beneficial. Your group facilitator’s primary responsibility is to create an atmosphere of safety and support in order for you to get the most out of group. Your group facilitator will encourage each group member to be honest, vulnerable, and respectful about his or her feelings and observations in the group.

If you are ever feeling unsafe in group you are encouraged to discuss this with your group facilitator. If for any reason you experience any negative reactions or blocks towards participation, please share this with the group. Your voice is your power and your right.

Knowing the risks of group therapy

There can be discomfort involved in participating in group therapy. You may remember unpleasant events, or experience feelings of anger, fear, anxiety, sadness, frustration, loneliness, helplessness, or other unpleasant feelings. If these distressful emotions arise during your therapy, please talk with your group and with your group facilitator.

During the process of group therapy, is normal to have intense feelings and reactions to other group members or even towards your group facilitators. Again, these are understandable emotions that should be discussed and processed in the group setting.

If you believe that group is not the most appropriate setting for you to heal and grow, please talk with your facilitator about other possible options.


It is important that you feel comfortable in group to talk freely about whatever is bothering you. Sometimes you might want to discuss things that you do not want those outside of the group to know about. You have the expectation of privacy in group sessions. As a general rule, group facilitators do not talk to anyone about what you discuss in group.

However, there are some exceptions to this rule. In some situations, in accordance with professional ethics and state laws, your facilitator may disclose information without your permission.

❖ Some of the circumstances where disclosure is required by law are:

❖ If you, a minor, a dependent person, or an elder adult is being abused

❖ If you are in danger of hurting yourself, someone else, or another person’s property

❖ When others communicate to your facilitator that you present a danger to others

If you are doing things that could cause serious harm to you or someone else, your facilitator will use his/her professional judgment to decide whether a duty to warn exists to ensure everyone’s safety. In these situations, your facilitator will talk with you about their concerns and discuss the best way to include your support system in order to get the support that you need.

Group member’s agreement for confidentiality

All members of the group will be asked to agree to a high level of confidentiality in the group sessions. This means that each participant agrees not to share any other group member’s identifying and personal information with others. It is appropriate to share your personal reaction and feelings about group with others, but please do not share other people’s stories with anyone outside of the group.


Please note that we may not be immediately available to handle emergency situations. If you are in need of emergency assistance, call ‘911’ or the crisis response team for your county of residency.  Unless otherwise specified, your therapist will return phone messages within 24 hours.

Consistent Attendance

It is very important that you consistently attend scheduled group therapy sessions. Although illness, unexpected events, or vacations may occasionally interrupt your therapy, consistent attendance plays a large role in helping you, and your fellow group members achieve your desired goals. Please be aware that your absences negatively influence the progress of yourself and the other group members. If for any reason you are not able to attend a group session, please inform your group facilitator.

Conclusion of group therapy

There are many different levels of care that therapists provide. Although group therapy is a very helpful tool for many people, the level of care offered at Ellie Family Services and with this group may sometimes not be the best match to your needs. If at any point during therapy your facilitator assesses that she/he is not effective in helping you reach your goals in the group setting, she/he will provide you and your parent/guardian with a number of referrals that may be of help.

Thank you for the time and attention that you took to read this document. We look forward to having you in group!

Please sign below to indicate that you understand and agree to the above, and consent to group therapy treatment. You are encouraged to keep a copy of this form, and refer to it from time to time during your therapy.

Client/Participant Signature:

__________________________________________  Date: __________

Client/Participant Printed Name:


Appendix Four

Appendix Five




We would like your feedback on your group experience at the Counseling Center.  This information is voluntary and will be kept confidential.  We appreciate your honesty and ask that you do not put your name on the sheet so that your responses will remain anonymous.  Your feedback will help us improve our group counseling services.  Fill out the form and return it to your group leader.

For #1-9, please circle the number along the scale that best represents your counseling experience:

Not    Strongly  Neither Agree    Strongly

Applicable    Agree     Agree    or Disagree    Disagree  Disagree

N/A 5 4 3 2 1

1. I made progress toward my personal goals in group counseling.                             N/A   5   4   3   2   1

2. I can work more effectively on my personal problems.                                             N/A   5   4   3   2   1

3. I can better understand my problems/issues.                                                               N/A   5   4   3   2   1

4. I can better communicate my thoughts and feelings.                                                 N/A   5   4   3   2   1

5. I am more sensitive to, and accepting of, differences in others.                               N/A   5   4   3   2   1

6. Group counseling helped me stay in school.                                                               N/A   5   4   3   2   1

7. I feel that I can better handle my feelings and behavior.                                           N/A   5   4   3   2   1

8. I have healthier relationships with others.                                                                    N/A   5   4   3   2   1

9.         I am satisfied with my overall group counseling experience.                                   N/A   5   4   3   2   1

(If disagree, please  explain) ____________________________________________________________________________________________



10.  What were the best features of this group?




11.  What didn’t you like or how might the group be changed?




12.   How could the group counselor/leader improve?




  1. Further comments on any of the above scales or about your group experience at the Counseling Center (use the back of this form if you need more room):




Group Counselor/Leader’s name    ____________________

Appendix Six

Appendix Seven

Boundary Exploration

Think about a person, or a group of people, with whom you struggle to set healthy boundaries. This could mean that your boundaries are too rigid (you keep this person at a distance), too porous (you open up too much), or there’s some other problem that isn’t so easily labeled. Who do you struggle to set healthy boundaries with? (e.g. “my husband” or “coworkers”)

In your relationship with the person you listed above, how are your boundaries in each of the following categories? Add a check in the appropriate column for each boundary category.

Boundary Category Porous Rigid Healthy Other
Physical Boundaries

Intellectual Boundaries

Emotional Boundaries

Sexual Boundaries

Material Boundaries

Time Boundaries

Take a moment to imagine what it will be like when you begin to establish healthy boundaries with this person. If your boundaries are too rigid, that might mean opening up. If they’re porous, it might mean setting limits and saying “no” when you don’t want to do something.

What are some specific actions you can take to improve your boundaries?

How do you think the other person will respond to these changes?

How do you think your life will be different once you’ve established healthy boundaries?

Appendix Eight

Appendix Nine

Appendix Ten

Cite This Work

To export a reference to this article please select a referencing stye below:

Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.

Related Services

View all

Related Content

All Tags

Content relating to: "Psychology"

Psychology is the study of human behaviour and the mind, taking into account external factors, experiences, social influences and other factors. Psychologists set out to understand the mind of humans, exploring how different factors can contribute to behaviour, thoughts, and feelings.

Related Articles

DMCA / Removal Request

If you are the original writer of this dissertation and no longer wish to have your work published on the UKDiss.com website then please: