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  III. APPLICATION 




CHAPTER FIVE IS A CONCISE SUMMARY
           AND SYNTHESIS OF THE COMPONENTS OF       

GROUP TRANSFORMATION LEADING TO

  THE DEVELOPMENT OF                                  

THE CRISIS INTERVENTION WORKSHOP.



CHAPTER SIX IS A DESCRIPTION OF       
   THE CRISIS INTERVENTION WORKSHOP.      



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CHAPTER 5


CONVERGENCE AND SYNTHESIS

"We converge for the psychical and deploy for the physical.”

                                                 •  R. Buckminster Fuller,
                                                                                          From a speech at Orange Coast College, 1976



As we gather together with other people, to meet and share ideas face to face, we are impinging a wealth of forces—psychical and physical—social trends, attitudes, outlooks, values, experiences, and abilities into a relatively small locus of time and space. The Group presents us with a type of crucible in which change and transformation take place. With so many ingredients and possible conditions many types of response are possible.

            Although this study has been presented in an orderly fashion beginning with the Foundations of Group Transformation for both the Group as a whole and members as individuals, proceding to specific structures of interaction, conditions for healthy change, then philosophy, theory, and techniques for transformation, it is possible for our study to dissolve into chaos under the sheer weight of ideas and information. It is important that the reaction be mediated and not left to random events, arbitrary interactions of particles of composition. Indeed, the Group, at times, seems to have a dizzying effect of sensory overload for participants. Even experienced members sometimes express exasperation or even a mild feeling of terror when overwhelmed with the possibilities of transformation.  


This is a description of a crisis.


In the midst of a Group discussion a member will unexpectently become angry or even burst into tears. It is time for Group members to stop, listen, and try to understand. Often there are deeper flows of emotion than those of which we are conscious. I would ask the person speaking about what they have not talked about but need to. The Group members may also be sensing issues or emotions coming to awareness. Sometimes the empathetic response is to recognize that there are feelings that are hard to experience and don’t seem to have any solution. This is an area for further discussion. I recognize the emotion and promise to return.

            Group members participate in many different manners, and the Group interaction undoubtedly has different meanings for each member. The chaos may also be interpreted as potential versatility. In the next chapter we will experience one highly pragmatic deployment of a small Group, focusing on this very sense of overload. This is the Application of this study, the training of competent Crisis Intervention counselors.

            In this direction and purpose we can see the workings of McDougall’s five principle conditions for raising mental life. (Cf. Chapter 1 above.) In the Crisis Intervention Workshops, Group participants are Psychiatric Unit and Emergency Room staff who work together every day. While the relationship of Group structure to the family as described by Freud, Fromm, Mead, and Cooley may exist as unconscious trends, these Groups are Primary Groups; the members have close work relations even before Group formation. The reason, nature, and goals of the Group are clear, although the process may be surprising.

           Groups composed of counselors from different backgrounds or institutions have common interest and a universe of discourse in their therapeutic approach that is the basis for Group Cohesiveness. Even when their individual training, techniques, and perspectives differ, there is a source of creative tension that brings us together as a Group: Universality based on individuation and personal development.

           At least part of one session explicitly has to do with interactions between various departments and disciplines of a general hospital or if participants come from different organizations or fields, we develop a common institutional model and find that we all develop a common experience to base a “sociodrama” game from. In a short time the Group develops a culture as well as an approach and methods that relate to successful Crisis Interventions research. Members play various roles including patients, interventionist, and Group leader.

            Tillich’s ontological questions of being and nonbeing influence the structure of both the crisis that the patient experiences as well as the structure and process of the Group. These are the ultimate issues of survival and positive development of the personality. Adler’s social interest and Mead’s interpersonal development of choice, mind, and self are at the heart of the crisis process and the intervention approach. Becoming Crisis Intervention counselors involves us in the practice of these communicational qualities as the extension of the Curative Factors and Therapeutic Ingredients.

            The patient in crisis is at the point of choice between Compulsion and Freedom, often experiencing overwhelming Guilt. This Guilt takes the form of confusion or extensive rigidity, both with a debilitating sense of anxiety. As a means of coping, this Guilt has become diffused into various symptoms. Focus on this Guilt may lead to pain too deep for the patient to process at this time. On the other hand, patients who use tight self-control to deal with crisis may feel they have lost this important quality. This loss has launched them into their crisis. They may feel themselves flooded with Guilt, even to the point of drowning. The counselor extends Forgiveness in the form his or her presence, embodying and communicating Curative Factors with the patient and in the style of the Therapeutic Ingredients. As counselors experience these in the Workshop, they may extend this experience to their patients.  

The organization of the workshop gives rise to a group process outlined below:

          Week 1:           Theory of crisis.


          Week 2:           Role-playing à Experience of crisis.


          Week 3:           Discussion of crisis experience à Theory of intervention.

   

        Week 4:           Theory and techniques of intervention. Role-play intervention.


          Week 5

& 6:        Role-play and develop interventions. 


The implicit group process may be described as follows:


Week 1:   “Crisis” is defined. This is done in such a way that it is brought into investigation as a universal process and experience. The anchoring of crisis in development is approached through Sullivan’s descriptions of the development of the “Self System”. The relativity of Sullivan’s Self-System tells us that each person’s self is built on foundations laid down in early childhood. In crisis we re-experience developmental crises. As such each of us experiences a certain disorientation at a time of crisis; our self concepts are threatened. The difference, then, between a healthy resolution to life crisis and an unhealthy resolution is a major theme of this workshop. Erikson’s developmental stages help us to understand a structure to crisis. This session ends with a certain anticipation, an open gestalt.

             

            Week 2:  Although we could study the theories of crisis intervention at this time, the experiential nature of the workshop and role-playing would be wasted. We would substitute an intellectual exercise for real life. The crisis experience is brought to the Group. It becomes part of the process and is shared between the members in triad role-playing.

              Weeks 3 & 4:  Now that we know what a crisis is, through a role-play experience, we can figure out how to intervene. Group members become resources for interaction and information. In role-play and Psychodrama we develop therapeutic attitude and direction; we figure out where to go with intervention.

              Weeks 5 & 6:   We have all the theory that we need at this time. The last step is to figure out what we are doing and practice, so that when a crisis arises, we intervene almost reflexively with maximum effectiveness.

                By the fourth week the workshop leader is done ‘leading’ and may be called on to structure a Psychodrama or role-play, act as a resource person, or encourage members to share experiences and knowledge with one another. Another important function of the leader may be to point out particularly relevant experiences or ideas brought up by members.  In this way each individual’s experience and approach becomes part of the experience of all members. The Group develops interventions for each member and each member contributes to a common Group experience.

                 In McAfee’s description, a person is encouraged to become aware of his or her Guilt and Freedom. They become aware, seek, and are extended Forgiveness, which leads to a transforming life experience. The Group as a whole undergoes this process as each member does. Forgiveness, in this case, is the process of working towards a therapeutic experience for all Group members.

              Lifton describes the healing process with the terms Confrontation, Reordering, and Renewal. In the workshop we experience crisis, experience intervention in the Group, and continue life with a new, deeper understanding of the crisis intervention process.   

              Finally, role-playing and Psychodrama are the basic acting through of the process, a form of continually evolving ritual that is both rehearsal and enhancement of life.



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