Social Work Research: Measuring Group Success
The 12-week psychoeducational support group for survivors of trauma I facilitated consisted of eight women (five of whom identified as Caucasian and three of whom were Hispanic in origin) who had a history of sexual abuse and/or incest. All of the women spoke English, were between 30 and 50 years old, and identified as heterosexual. One woman in the group was married, and the rest were either divorced or single. Five of the women had children. The majority were gainfully employed except for one group member who had multiple sclerosis and was on Social Security Disability Insurance. Members were recruited via internal agency referrals or referrals from other social workers. All members were required to meet individually with a social worker while they attended group.
The majority of the group members were incest survivors; only two were molested by strangers. All of the members had struggled with post-traumatic stress disorder (PTSD) symptoms that included hypervigilance, nightmares, flashbacks, and anxiety. The abuse had affected their interpersonal relationships, professional growth, self-esteem, and general quality of life. The majority of incest survivors in the group had estranged themselves from their families as a result of anger and resentment toward a parent who did not protect them from the abuser.
My treatment goal was teaching group members how to accept and integrate their abuse into their life narratives so that the events did not define who they were as individuals. With the tools learned during the group process, members would then be able to manage their lives, utilizing learned mindfulness and relaxation techniques, positive affirmations, and coping skills that would assist them in making healthy life choices.
During each of the 12 weeks, I covered a specific topic related to life issues affected by sexual abuse. All members were asked to sign confidentiality agreements and review group rules during the first meeting. Members’ feelings were validated and supported throughout the process. I gave a pretest to each member in the form of a Depression Anxiety Stress Scale (DASS). The scale was administered in order to measure members’ current emotional baselines before being exposed to the therapeutic group process. The basic 42-item questionnaire was known to have high internal consistency and to yield meaningful discriminations in a variety of settings. Members were asked to use 4-point severity/frequency scales to rate the extent to which they had experienced each state. The Likert scale indicated a “0” for the least depressed/anxious/stressed choice and “3” for the most depressed/anxious/stressed choice per item. Total scores ranged from a minimum of 0 (no distress) to a maximum distress of 126. Scores for each symptom were summed, and the higher scores indicated more distress. The pretest scores summed by symptom for group members consisted of the following: depression 210, anxiety 138, and stress 190.
I utilized a feminist empowerment model and strengths perspective framework during the group process. The model focused on strengthening women in such areas as assertiveness, communication, relationships, and self-esteem. Members were then able to develop the tools needed to reach their potential as unique and valuable individuals.
Group cohesion had formed by the third session as members felt more comfortable sharing their personal stories, feelings, and experiences with sexual abuse. The psychoeducational format enabled members to increase their knowledge over the course of the sessions in such topics as dealing with crisis, survival skills, anger, challenging negative schemas, healthy support systems, self-esteem, building healthy relationships, healing sexually, and, finally, mourning losses and moving on.
I administered the DASS posttest in week 12 to measure any emotional changes. With “0” being the least depressed/anxious/stressed and “3” being the most depressed/anxious/stressed choices, the summed scores for all symptoms dropped 72% and reflected those of the eight members who remained in the group through the last session when the posttest was administered. Posttest summed scores resulted in depression 45 (vs. 210 pretest), anxiety 45 (vs. 138 pretest), and stress 61 (vs. 190 pretest), attesting to the validity of the current group format. In addition, the members were given an agency evaluation qualitative measurement form to fill out in order to rate member satisfaction with the agency’s group format. The evaluation form consisted of some questions in yes/no format and others as fill-ins. Answers were positive for all members. Finally, members were given “diplomas” consisting of an inspirational affirmation based on the principles of dignity and self-worth.