Coping with Family Trauma

A therapeutic process group treatment for

college students

Jack Mack, Ph.D.Buffalo State College Counseling

Center

Outline• Basic structure• Group agreements and norms• Screening and construction• Process vs. support group• Mindfulness• Common themes, challenges,

interventions• Why this group works, client feedback• Q & A

Basic Structure• Theme / Purpose– 66% of college students reported Criterion A

trauma– 9% met criteria for PTSD

• Description of group– Length/Frequency– What we do each week– Our stance

• Short term (1 semester w/ option to continue)• Recruitment (what we tell our colleagues)• Leader(s) – ideally male/female coleaders

Read, J.P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM-IV-TR trauma exposure and posttraumatic stress disorder among newly matriculated college students. Psychological Trauma: Theory, Research Practice, and Policy, 3(2), 148-156.

Basic Structure• Mindfulness exercise• Check-in–How are you feeling right now? (Feelings Wheel)– Any updates on family contact since last group?– Any specific topic/issue to address today?

• Group process (based on above)• Check-out–How are you feeling right now?–What is something from group you connected

with?–What is a small goal you could work on before

next group?

Group Screening & Construction

• Hand out screening form• What goes into group construction?– Demographics (gender, age, grad or

undergrad)–Matching vs. Diversity–What types of traumas fit in group?–Heterogeneity vs. homogeneity (Yalom, 1985)– Potential problems (leaders, wallflowers,

attendance, boundary issues, talking too much or too little, etc.)

• Rule-out criteria

Group agreement and norms

• Confidentiality, limits of confidentiality• No contact outside group,

subgrouping• Attendance• Commitment (at least 3 sessions)• No physical contact• I-statements• Asking members for what they want to

add, put it in their own words

Process Group vs. Support Group vs. Structured Group

• We don’t have an agenda, but we have themes/skills that we cover

• Some structure (check-in, check-out) open process part is sandwiched in the middle

• Process—present oriented, coping oriented• Activities based on group topics/interest• Emphasis is not processing trauma, more

helping to cope w/ trauma in the present

Mindfulness Exercise

• We begin and end with a mindfulness and/or relaxation exercise.

• Demonstrate difference techniques over the semester.– Breathing–Movement– PMR– Guided meditation– Apps

Common Themes• Anxiety, depression, PTSD• Triggers• Balance, self-care• “Overcontrolled” vs. “Undercontrolled” reactions to

trauma• Boundaries with family, friends, partners• Emotional intelligence/processing• Loneliness, stigma• Replicating family patterns

– Substance use/abuse– Chaotic relationships

• Trust, acceptance, and/or forgiveness• Siblings, roles in family• Reasonable goals/expectations for self/family

Common Challenges

• Attendance (group and individual)• Current traumas vs. past traumas• Disorganization• Trust• Subgrouping (age, gender, type of

trauma)• Crisis management• Clients acting in therapist/helper role• Termination, saying goodbye healthily

Common Interventions• Present/coping-focused• Setting reasonable/attainable goals• Skill building – mindfulness, self-validation,

seeking social support and safety• Psychoeducation • Understanding/improving communication– I statements– Speaking the unspoken– Ask for/give direct feedback when it feels safe

• “Genograms” – What does your family look like? What is each

person’s role? Has this changed? How would you change it?

Why this group works

• Universality, reduced isolation• Validation• Emotional processing• Problem solving• Interpersonal

feedback/learning/practice• Altruism, pride, resilience• Reinforcing strengths• Installation of hopeYalom, I.D. (1995). The theory and practice of group psychotherapy (4th ed.). New York: Basic Books.

Anonymous client feedback(used with permission)

• “I got a lot of good feedback from people who understood where I was coming from and I think that really helped.”

• “I never thought that being in this group would be as hard as it was and I didn’t think it would have such a profound effect.”

• “It really helped me to cope with my depression.”• “I didn’t expect that I would have such a positive

impact on other group members. It was amazing to hear feedback from peers, pointing to strengths they see in me, especially when I feel so broken.”

• “It definitely pushed me to take risks in a healthy, unintimidating way, and it helped me seek and give support to others.”

• “I am not alone.”

Questions?