Gathering people in groups for a mutually beneficial purpose is a natural tendency for human beings. Through groups, individuals can achieve various objectives and associate with each other productively and innovatively. Sometimes people need groups to survive and thrive, an interdependence visible in all group types, from task-oriented to therapeutic ones. For effectiveness, group leaders must recognize the potency and power of these gatherings and preplan to be prepared for all the stages of the group’s development. They also must use the appropriate skills to help with the effective and smooth development of the group to achieve its set objectives. In this case, the proposed group is a support group for parents of children and adolescents with mental illness. Often, parents are the primary caregivers of their mentally ill children, and they forget to take care of themselves while simultaneously caring for their children. With the increased prevalence of mental illness in the United States, the issue is about to be exacerbated hence the need for planning for this support group. Therefore, using relevant literature and articles to plan the formation of a support group for parents with mentally ill children and adolescents under different facets is eye-opening to the importance of preplanning for effective group outcomes.

The Need for the Group

Family members caring for relatives with any significant illness face difficulties that transcend all their life's aspects. These difficulties include; poor emotional and physical well-being, limitations on occupational, recreational, and social opportunities, feeling isolated, grief, and loss (Navaneetham & Ravindran, 2017). Additionally, caregivers for those with a mental disorder or illness may face dangerous and antisocial behaviors, stress due to shame and stigmatization, the uncertainty of an episodic and unpredictable illness, and the experience of complex loss and discrimination (Navaneetham & Ravindran, 2017). Due to the continuous and inevitable emotional involvement, these caregivers are often deeply traumatized by their child's illness. They often neglect their psychosocial and physical needs because they mostly focus on their ill child or adolescent's psychiatric treatment and mental health. The uncertainty about the prognosis and course of their child's ailment and the potential for recovery also makes them have high levels of stress and anxiety that burden them (Foroughe et al., 2018). Parents must adjust and adapt to their new roles as informal caregivers despite feeling unprepared to properly care for their mentally ill children. Unfortunately, due to the stigma associated with mental illness, family members, including parents of the afflicted child or adolescents, may be reluctant to seek help.

Group interventions involving parents help improve the parents' knowledge, practices, and skills. Group-based parenting programs significantly improve the parents' psychosocial health, responsiveness, and parent-child relationships (Chien et al., 2018). Additionally, they provide parents the opportunity to get understanding, supportive interactions, experiential learning, emotional ventilation, and participatory learning, which effectively facilitate the process of attitudinal and behavioral modification, which is valuable for the treatment process of their children. A stressful interpersonal environment in the family setting can worsen mental illness symptoms; hence targeting the parents in group therapy is vital in illness management and is an evidence-based guideline (Foroughe et al., 2018). Although medical professionals acknowledge the crucial role of parents in their child's mental health care, they are often overlooked when delivering evidence-based treatment. They are only involved in issues concerning the primary clinical work with their child (Foroughe et al., 2018). Attending to parents' needs and emotional reactions is crucial for the child's recovery. Thus, groups offer a holistic approach that considers psychosocial management modes and external environmental factors.

Mental health is crucial to a child's well-being and includes emotional, mental, and behavioral well-being. Mental disorders in children refer to severe alterations in their typical learning, behavior, or emotional handling skills resulting in issues and distress as they go through their lives. There are various ways to evaluate mental disorders in children and adolescents, such as the National Survey of Children's Health (CDC, 2022). This measure describes the presence of indicators of mental health issues and helps identify the number of individuals with mental disorders, and tracks their treatment. The prevalent mental health issues in children and adolescents in the United States include anxiety, attention deficit and hyperactivity disorder (ADHD), depression, and behavior problems. Approximately 6 million, 5.8 million, 5.5 million, and 2.7 million children received a diagnosis of ADHD, anxiety, behavior problems, and depression, respectively, between 2016 and 2019 (CDC, 2022). Unfortunately, some of these conditions often occur simultaneously. For instance, approximately three out of four depressed children also had anxiety and behavior problems. For adolescents, substance abuse, depression, and suicide are significant concerns (CDC, 2022). Children diagnosed with a mental disorder may continue to suffer from the illness during adolescence. These children and adolescents are often taken care of by their parents, hence the relevance of a support group that can enable them to do so effectively.  

The Group Concept

The primary purpose of this group is to ensure that parents with children or adolescents with mental illness can take a primary role in their child’s recovery or management of the disease without neglecting themselves in the process. The group will also use the growth and education groups framework as classified by the Boston University group work faculty (Shulman, 2015). The rationale for this framework is that they are suitable for people going through major life development transitions or difficulties or individuals with delayed skill development due to stagnating and regressive influences, such as people with mental health conditions needing long-term chronic care. This kind of group focuses on learning certain competencies and social skills needed for the development task (Shulman, 2015). The framework is thus applicable as the support group intends to equip parents of children with mental illnesses with the necessary skills to give quality care to their mentally ill children. Additionally, the parents are also equipped with skills for their self-care to ensure their psychosocial and physical well-being while simultaneously caring for their mentally ill child or adolescent. The group will provide the parents with peer support, which is an integral part of the child’s recovery and helps reduce the caregiving burden and improve the parent’s stress management (Chien et al., 2018). By doing all this, the parents will be better positioned to care for their mentally ill child while taking certain steps to take care of themselves, providing a holistic and excellent environment for the child’s recovery of effective management of their illness.

The Group and its Fit Within the Agency

Rather than deciding on beginning the group and seeking staff members' suggestions, the group idea will be used to influence the staff. This way, there will be the illusion that they were involved in the idea's conception, increasing the probability of gaining their support (Shulman, 2015). They will also have room to give their input and suggestions regarding the group. The staff might have several concerns or issues with this new group, including the selection criteria for the facilitator, and how the facilitator will deal with the group member's divergent interests. The issue of divergent interests among the group therapy members will be addressed by the facilitator helping the members find common ground (Shulman, 2015). With the group's development, the members will find a more mature way of relating as they comprehend that their learning and growth can come from giving and receiving help (Shulman, 2015). The facilitator will be a volunteer from the agency who feels passionate about the group and its purpose. The facilitator will also perceive other staff members as colleagues and develop agreements that mutually share relevant information (Shulman, 2015). The clients will also not be part of other interventions within the agency to ensure the effectiveness of the group can be accurately determined and to eliminate the complex communication process between the involved staff. Nonetheless, the group will require the agency's support through refreshments, space, and referrals (Hope Health, 2022). Effective communication with the staff will thus result in tips on improving the proposal and the group's efficiency.

Description and Design of the Group

To be eligible, one has to be a parent (male or female) to a child or adolescent with a diagnosed mental illness, be their primary caregiver, be aged 18 and above, and belong to any race and socioeconomic status as long as they understand English. Parents with an existing mental illness will be excluded from this group. The group will be heterogeneous regarding the mental illnesses that the children and adolescents have and will target regional psychiatric outpatient clinics in the United States (Chien et al., 2018). Nonetheless, self-referrals and agency referrals will be acceptable. The group will be open, meaning there are no restrictions on the number of participants joining or leaving the group in every session (Chien et al., 2018; Shulman, 2015). A clinician will, however, evaluate the client's ability to work in a group and their needs and desires through individual interviews before they can join. The orientation process will involve introducing the members, the new member, and the facilitator, restating the group's purpose and expected outcomes, and asking the new member to state their expectations, values, and desires (Shulman, 2015). Suppose the individual is unsuitable for the group. In that case, the clinician will respectfully inform them why the group is unsuitable and recommend groups or resources that would be more helpful to them. The agency will then contact them through email later to follow up if they found the appropriate resources and if they need further help. If the group used a flyer, it would say, "Help yourself as you help others." The group will meet at a place designated by the agency for two-hour bi-weekly sessions (Chien et al., 2018). The room will offer privacy to the members, have comfortable chairs, and include face-to-face seating in a circle. After the meetings, refreshments will be served to grant the group members a space to socialize outside the group setting and relax after the session.

Contract

Contracts and rules will govern the group. The mutual contract will be there for the entire group. In this contract, the facilitator and the clients reorganize and reintegrate their objectives with those of the entire group. On the other hand, the facilitator must integrate each client’s therapeutic objectives into that of the entire group, developing new objectives for the group (Krystof, 2021). The group members will own the mutual contract, and none of them can alter it without seeking the consent and approval of the facilitator and other group members. Nonetheless, the group will purposefully and deliberately modify the mutual contract as the sessions continue. Confidentiality of the information the group members disclose will be a non-negotiable rule that includes the social worker and the group members (Shulman, 2015). Although they can narrate their experiences, they are restricted from divulging the other group members’ information to anyone outside the group setting. Each member is expected to attend every session; when unable to do so, they must inform the facilitator before the session. Anyone wanting to quit the group should attend an extra session to discuss their concerns (Shulman, 2015). The group will develop negotiable rules depending on their needs and concerns with the inquiry of the facilitator during the first group session. Lastly, there will be no fees for participating. Overall, the contract and rules help make the group members more comfortable sharing, improving their growth process.

Outline Plan for Group Sessions

The group proposed is a mutual aid group; hence there will be expectations of the emergence of several themes with time. The mutual aid group is suitable due to its various attributes, including the "all-in-the-same-boat" phenomenon, where group members feel supported and less isolated when they discover other members with similar concerns, issues, emotions, and lived experiences (Shulman, 2015). This group also allows the members to view their issues in a social context characterized by less personal blame. The mutual aid group is also characterized by data sharing, which is vital due to the differences in the members' life experiences that can enrich the group with diverse values, knowledge, and perspectives (Shulman, 2015). The group members also support each other emotionally, facilitating the parent's growth process. Some emergent themes would include; the parents' feelings and thoughts, the need for support, parent-child relationships, substance abuse, coping skills, education on specific mental health conditions, coping mechanisms, emotional wellness, trauma, and self-care. These themes center around the parents' emotions when catering to their mentally ill child or adolescent, negative coping mechanisms, their role in the child's life, and gaining skills to care for themselves and their child.

Facilitators

The group facilitator is primarily a mediator between the group and the individual, enabling an effective individual-group interaction. Consequently, the facilitator's clients are the individual and the group, and they must consider their concerns. For instance, the facilitator lets individuals air their concerns with the group (Shulman, 2015). As the group facilitator enables the group interaction, they also must monitor if the group members are attentive and relate with the member speaking. If they seem disinterested, the group facilitator will explore their reactions and emotions for more insight. It could be that the details being divulged are evoking a strong emotional reaction, making it challenging for them to listen (Shulman, 2015). The group facilitator is also responsible for identifying obstacles to achieving the group objective and communication, enabling the members to identify and discuss their feelings about certain issues. If I were to be one of the facilitators, I would require various skills to be an effective group leader. One of them is making the client's feelings tangible by expressing them in words (Shulman, 2015). This skill involves the observation of non-verbal cues and indirect communication before the client's direct expression. I also need the skill to share my emotions appropriately through nonverbal and verbal communication. These emotions must be shared professionally during my function as a group leader (Shulman, 2015). Some of the challenges in this line of work include; poor communication, unequal contribution by the members, and managing aggressive members. Despite these challenges, speaking to a supervisor and continual engagement with the group will improve my communication skills, improving my role as a facilitator.

After completing this assignment, the value of preplanning for effective group outcomes is apparent. Preplanning gives one a clear idea of their objectives and intentions when establishing the group. This way, one does not deviate from their intended purpose, or if a deviation occurs, one can get the group back on track. Preplanning also enables one to execute the plan smoothly as one anticipates obstacles and finds possible solutions to overcome them. Additionally, one can identify one’s weaknesses that would impede the achievement of group objectives and find ways to improve one’s skills. Overall, preplanning is vital for effective group outcomes as it enables the formulation of objectives and allows for risk management through planning for possible obstacles.

References

CDC. (2022). Data and statistics on children’s mental health. Centres for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/data.html.

Chien, W., Bressington, D., & Chan, S. (2018). A randomized controlled trial on mutual support group intervention for families of people with recent-onset psychosis: A four-year follow-up. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00710

Foroughe, M., Stillar, A., Goldstein, L., Dolhanty, J., Goodcase, E., & Lafrance, A. (2018). Brief emotion focused family therapy: an intervention for parents of children and adolescents with mental health issues. Journal of Marital and Family Therapy, 45(3), 410-430. https://doi.org/10.1111/jmft.12351

Hope Health. (2022). Hope Health Systems Inc. – Providing hope and help to families since 1999. Hopehealthsystems.com. https://hopehealthsystems.com/.

Krystof, D. (2021). Learning contract in adult education – experiences and best practices. Edulearn Proceedings. https://doi.org/10.21125/edulearn.2021.0530

Navaneetham, N., & Ravindran, D. (2017). Group work intervention for the parents of children with mental health issues admitted in the tertiary care center. Indian Journal of Psychological Medicine, 39(4), 430-435. https://doi.org/10.4103/0253-7176.211762