Introduction
Diverse, cultural and minority groups have important considerations essential to successful group work. This essay will explore the key elements of group processes and group dynamics when working with diverse groups and individuals to include the following: working relationship with group members, ethical and legal issues, group leader skills and the impact of diversity in group settings. This essay will also examine the challenges and limitations of working with diverse groups and suggest ways practitioners can become informed by preparing for these potential issues. This essay will focus on issues specific to Aboriginal and Torres Strait Islanders (ATSI) across Australia and examine considerations unique to this culturally diverse group.
Indigenous Groups
According to research, around seventy per cent of Indigenous deaths occur before the age of 65, compared with twenty-one per cent of non-Indigenous Australians (Purdie et al, 2010). These family losses have lasting impacts on families and communities highlighting concerns for government to address psychosocial issues as a result of Aboriginal disadvantage. To aid the recovery and healing process of First Nations People, Australian peak bodies now recognise the need for practitioners to engage in a culturally diverse approach in providing therapeutic support. The Psychotherapy and Counselling Federation of Australia (PACFA) co-facilitated the formation of The College of Aboriginal and Torres Strait Islander Healing Practices (CATSIHP) in 2018 to address the trauma of generations of Aboriginal and Torres Strait Islander peoples (PACFA, 2021). Group work is now considered an evolving area of therapy through which to address mental and physical health and wellbeing in our Aboriginal communities, however, practitioners also need to be informed about the Guiding Principles that make interaction with this minority group successful (Purdie et al, 2010). The Nine Guiding Principles emphasise the holistic and whole-of-life view of health held by Aboriginal and Torres Strait Islander People, endorsed by Commonwealth, state or territory governments. These principles acknowledge the Aboriginal connection to land and identify Indigenous creativity, strength, and endurance and deep understanding of the relationships between human beings and their environment (NIAA, 2017).
Purdie et al (2010) argue there is an overall lack of current resources to assist health practitioners when working with Indigenous Australians experiencing social and emotional issues across the lifespan. This is generally because therapeutic programs have little cross-cultural validity (Purdie et al, 2010). To work effectively with this minority group, it is important to understand health through the cultural lens of an Indigenous Australian. The Aboriginal community view mental health through a holistic lens and practitioners are encouraged to adopt an approach that includes social and emotional wellbeing factors to individuals and communities. Calma (2005) argues practitioners need to break down health silos that separate family violence, mental health and substance abuse services and integrate them as a single holistic health service to link these intergenerational issues (Calma, 2005). The effects of historical colonisation and oppressive legislation have allowed Indigenous Australians to demonstrate unique protective factors as a source of healing and strength through their experience of grief, loss, and intergenerational trauma (Calma, 2005; Goldingay, 2016; Green, 2011; Morseu-Diop, 2017).
Group Process
The Group process focuses on the different forms of communication among group members, the participation of individual group members, and the level of cohesion in a group. The group process begins at the Intake stage which provides an opportunity for candidates to receive initial information, and for facilitators to understand client motivation, expectations, commitments, and reasons for engaging in western-style group work. The pre-group meeting assists culturally diverse participants to become familiar with one another, the proposed venue, facilities, and understand program content as it relates to the group aims and objectives.
The Tuckman Model is used to scaffold many different group types and is arguably the most recognisable group model that is used today (Bonebright, 2010; Brown, 2011; Kiweewa et al, 2018). The model consists of five important stages: Forming, Storming, Norming, Performing and Adjourning. According to Tuckman (1977), every stage has its own distinct features and structures and involves a task and emotional element. Tuckman hypothesised that task elements dominated highly structured groups (work/task or psychoeducational groups). In counselling or psychotherapy groups, the emotional element is likely to dominate (Erford, 2018; Tuckman, 1977). Tuckman observed transitions from stage to stage can be gradual or episodic and noted the possibility of groups regressing back to previous stages, skipping stages, or becoming stuck within a given stage thus relying on the group leader to move them safely along.
As the group is formed and individuals begin to feel more comfortable in their new environment and one other, group norms begin to emerge. Common ideas and differences between individuals are brought into focus and some alliances and sub-groups may be formed. Many participants may continue to look to the group leader to provide safety, security, and leadership. Some members may feel discomfort as they observe hostility demonstrated to one another and the group leader through differing opinions and world views. Some participants may even question whether this is the right group to help them achieve their goals. It is important for the group leader to demonstrate strong leadership skills, security, competence, and a flexible approach to encourage collaboration of members as they move through the various stages (Toseland & Rivas, 2017).
When considering a culturally appropriate and safe space for an Aboriginal group, facilitators may consider the importance of working with a respected community leader, such as an Aboriginal Elder to create trust amongst group participants. It is also important to use tools that are consistent with Aboriginal values to include rituals and ceremony like dance, movement, art, crafts, music, and yarning (Healing Foundation, 2017). These activities allow Aboriginal group members to feel comfortable in the group environment, removing potential cultural barriers. Sometimes it can take a significant time to build trust in Aboriginal individuals and communities and many organisers may consider inviting participants to join a drop-in centre a few weeks ahead of the group program to create rapport through informal meetings.
Through years of colonisation and historical oppression, many Aboriginal people feel disempowered of white people (Green, 2011). It may take time for them to develop trust, engage in dialogue and develop a working relationship before they will agree to work therapeutically. When thinking about potential tools for holistic Aboriginal healing, it is important to understand the Aboriginal belief of establishing balance in the domains of mental, spiritual, emotional, and physical health. The Indigenous Medicine Wheel, and Yarning Circle of Life, are cultural tools developed to support group work interaction and healing (USC, 2021). Implications for practice include incorporating the concepts of balance, holism, and cultural healing into the health care services (Clarke, 2008).
In contrast to western modalities, Aboriginal people prefer to visit community Elders to discuss their personal and family problems through informal conversation termed yarning. Aboriginal people also prefer to use intergenerational natural healing techniques and bush medicine comprising plant leaves, seeds, and tubers from the plants available in their own territory (Clarke, 2008). These are ideas to incorporate into an Aboriginal program, with Aboriginal art displayed to create a warm and welcoming safe space.
Aboriginal Community Healing Centres are ideal places to provide group therapy programs because relationships and trust have already been build. First Nations people believe the only way to heal intergenerational trauma is by reconnecting with identity, land, and culture with strategies to address child safety and wellbeing; community safety; spiritual healing; self-determination; and leadership and governance (Healing Foundation, 2017). These are potential areas to connect with Aboriginal individuals and communities.
Education has historically been a barrier in connecting with the Aboriginal community because many families fail to see the value of attending school or have experienced disappointment with the education system. Adult learning is an alternative education system to facilitate motivation and self-development with adults and young people when they identify something they want to know or become proficient at. Participants become ready to learn when they need to cope effectively with real life situations (Crowther & Sutherland, 2008; Knowles, 2011). Adult learners want to be engaged in life-centred or problem-centred learning experiences to develop confidence, empowerment, personal growth, self-esteem, and attainment of goals. The adult learning concept can provide help and assistance to Aboriginal young people and adults, as they are encouraged to find practical solutions to current problems and achieve life goals (Knowles, 2011).
Group Dynamics
The intersectionality of socio-economic backgrounds, values, beliefs and contrasting personalities within the group environment can often set the scene for potential conflict, misunderstandings, stereotyping and misinformed judgement. It can also provide an opportunity for the development of empathic relationships and natural alliances (Toseland & Rivas, 2017). Culturally diverse groups can often be misunderstood due to cultural norms and values therefore, it is important for group leaders to be mindful of the experiences of diverse members relating to oppression and their feelings about themselves, their identity, and local communities (Sue, 2019; Toseland & Rivas, 2017, p.161).
Many processes are easily observable within the group however group dynamics are much harder to observe. Many participants experience a reaction to the discussion material, experienced as transference, countertransference, or defence mechanisms as a reaction to triggering memories stored within the consciousness. These thoughts, feelings and emotions can become heightened and will influence other group members as subtle and obvious reactions are observed by others. Some participants may become triggered by an individual’s personal reaction. This can create a wave of ongoing effects that can spiral and take over the life of the group as it shifts and takes on its own identity. Presenting an opportunity for new learning and creativity through reflection and consolidation, the group leader can change the direction of the group discussions when these shifts and periods of high energy interactions are observed. It is important for the group leader to be aware of the factors influencing the current pattern of group interaction and how they can be moved into another domain.
Challenges
Working with diverse groups brings many challenges to group work. Many cultures are not experienced in talking about their personal feelings and some participants may feel reluctant to disclose personal information or share family conflicts (Corey et al, 2018). Some individuals and cultures view personal issues and conflicts as shameful and find it difficult to share with strangers. Others may prefer to seek help from extended family members, clergy, or Indigenous Elders rather than engage with professional services. Some participants may refuse or be reluctant to join a group because they are unfamiliar with how groups work, and some people find what is expected of them clashes with their cultural values (Corey et al, 2018).
The challenges of working with an Aboriginal group can include specific factors relating to historical colonisation, intergenerational trauma, structural disadvantage, lack of local government resources, and an overall mistrust of white Australians. Other factors include the perception of power over Indigenous Australians, language, and participants’ ability to read and write; especially if the counselling approach involves some form of writing interaction such as Cognitive Behavioural Therapy (CBT). Many Aboriginal participants have no desire to learn about western forms of healing, preferring traditional bush remedies and consulting with community Elders through yarning and ceremony rituals. The cultural divide of western society and Indigenous Australians causes an obvious barrier to prevent Aboriginal communities engaging with western therapeutic services. The answer must lay in creating trust with the Aboriginal community to merge western therapy approaches within an Aboriginal cultural practice.
Group Leader
Groups have unique therapeutic power and can be used to encourage positive developmental growth by empowering clients or may have a detrimental effect by inducing indirect psychological harm. It is the responsibility of the leader to guide the direction of the group to positive outcomes using skill, personal characteristics, style, and competence (Corey et al, 2018). Group leaders need to be skilled and experienced to adapt, anticipate, and move through group stages as and when they arise. The group leader will establish group goals and objectives and support the group to establish agreed guidelines to promote safety and positive open communication. The group leader will also need to be aware of their own power and influence over the group, especially in the early stages of the group process. Group leaders will also facilitate the group’s decision-making process and promote group cohesion, being mindful of any potential ethical obligations along the way (Corey et al, 2018).
When considering cultural diversity and other minority groups, it is important for group leaders to be aware of their own world view, beliefs, values, and bias based on their own experiences and socialisation. Group leaders need to be familiar with cultural diversity and be aware some members may struggle to express themselves directly, due to their cultural values and indirect style of communication. Some group members may find it difficult to ask for time within a group because it is considered rude, insensitive, and self-oriented in their personal culture. These examples demonstrate the potential difficulties in running a group with cultural diversity, highlighting the need for practitioners to be culturally sensitive (Corey et al, 2018, p.77).
In an Aboriginal group, it is important for an Aboriginal Elder to assume the role of group leader to create trust and respect amongst group participants. It is also important to use tools that are consistent with Aboriginal values to include rituals and ceremonies (Welcome to Country Ritual, or a cleansing Fire Ceremony). These activities allow participants to feel comfortable in the group environment, reducing cultural barriers. Group leaders also need to decide how they will work and connect with the Aboriginal community. This is usually through a ‘gatekeeper’ or Elder who can make necessary introductions and provide knowledge and advice on how to connect with the Aboriginal community. When designing the group, leaders need to decide whether it will be an exclusive Aboriginal group, or whether there is value to offer a heterogenous group, depending on goals and objectives.
Ethical and Legal Issues
Ethical issues relate to the standards that govern the conduct of professional members. Legal issues relate to minimum societal standards upheld by legislation at a state or federal level (Corey et al, 2018, p.59). Many of these issues are usually identified and addressed as part of the initial group guidelines that are written and agreed by all group members. Considerations will usually be made for confidentiality and informed consent, however, in the example of culturally diverse groups, additional considerations will be made for cultural diversity, competence and training, and group techniques (Corey et al, 2018, p.59). Addressing diversity issues is considered an ethical obligation for group leaders. Debiak (2007) argues many psychotherapy group leaders have a personal bias embedded in a white, middle-class, heteronormative worldview (Debiak, 2007, p.10). Other areas of consideration include screening and orientation of group members; voluntary and involuntary group membership; group leader preparation and behaviours; multiple relationships in group work; record keeping, and billing (Rapin, 2010, 2014). There are further mandated issues that can be viewed through the lens of a practitioner’s duty of care to report any knowledge of child abuse and neglect, or criminal harm to others. Another form of breaching ethical guidelines is the practitioner accepting gifts from clients. This can be a difficult situation to navigate if the client is from a culturally diverse background and may feel highly offended if the gift is refused.
Conclusion
As societies embrace multiculturalism, there is a greater need for group practitioners to respond to the growing interest in diverse group members. This is an opportunity for growth for practitioners and Aboriginal participants to work together through evidence-based practice of therapeutic group work to support healing from intergenerational trauma. Practitioners are asked to move beyond their own personal values and bias to understand and support the healing needs of our First Nations People. This collaboration will create a positive future for our children that is free from the trauma that is Australia’s past.
References
Bonebright, D. A. (2010). 40 years of storming: a historical review of Tuckman’s model of small group development. Human Resource Development International, 13(1), 111-120.
Brown, N. W. (2011). Psychoeducational groups: process and practice (Third edition). Routledge.
Calma, T. (2005). Indigenous mental health. Speech by Mr Tom Calma at the Djirruwang Aboriginal Health Program, Charles Sturt University, Student Conference, 29 September 2005, http://www.hreoc.gov.au/about/media/speeches/social_justice/indigenous_mental_health.htm
Clarke, P. (2008). Aboriginal healing practices and Australian bush medicine, The Journal of Anthropological Society of South Australia v.33, 3-24.
Corey, M. S., Corey, G., & Corey, C. (2018). Groups: process and practice (10th Ed). Cengage Learning.
Crowther, J., & Sutherland, P. (2008). Lifelong Learning. Routledge.
Debiak, (2007), p.10. Attending to diversity in group psychotherapy: an ethical imperative. International Journal of Group Psychotherapy, 57(1), 1-12
Erford, B. T. (2018). Group Work: Processes and Applications, 2nd Edition. Taylor and Francis Group.
Goldingay, S. (2016) Building relationships and effecting change: critical social work practice in prison settings. In Pease, et al (2016), Doing Critical Social Work: transformative practices for social justice. Allen and Unwin.
Green, G. (2011). Developing trauma training for an Indigenous community: hopefully not seagulls. Australian Social Work, 64(2), 215-227
Healing Foundation (2017). Healing Forum Reports. https://healingfoundation.org.au/healing-forum-reports/
Kiweewa, J. M., Gilbride, D., Luke, M., & Clingerman, T. (2018). Tracking Growth Factors in Experiential Training Groups Through Tuckman’s Conceptual Model. The Journal for Specialists in Group Work, 43(3), 274-296.
Knowles, M., Holton, E., & Swanson, R. (2011). The Adult Learner. Routledge.
Morseu-Diop, N. (2017). Healing in Justice: Giving a voice to the silent and forgotten people. Magpie Goose Publishing.
NIAA (2017). National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being 2004–2009, p. 6
PACFA (2021). More than words, the College of Aboriginal and Torres Strait Islander Healing Practices is ‘reconciliation in action’. https://www.pacfa.org.au/Portal/News-and-Advocacy/News/2021/More_than_words_the_CATSIHP.aspx
Purdie, N., Dudgeon, P., & Walker, R. (Eds.) (2010). Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice. (1st ed.) Commonwealth of Australia. https://research.acer.edu.au/indigenous_education/24/
Sue, D. (2019). Counselling the culturally diverse: theory and practice (8th ed.). Wiley.
Toseland, R., & Rivas, R. (2017). An introduction to group work practice (8th edition, Global edition.). Pearson Education Limited.
Tuckman, B. W., & Jensen, M. A. C. (1977). Stages of Small-Group Development Revisited. Group & Organization Studies, 2(4), 419-427.
University of the Sunshine Coast (2021). Yarning Circle of Life. https://www.usc.edu.au/profiles/indigenous/the-yarning-circle-of-life