Precautions and Practical Tips
Workers’ Qualities

1. Acceptance

Because they are often labelled as disruptive and are unwelcomed by their peers, it is very important to offer ‘acceptance’ to proactive aggressors and aggressive victims. In this study, the workers’ attitudes and acceptance of group members influenced the level of trust between the members, workers and other members, especially in the first group session. Workers should maintain a non-judgmental attitude towards group members, understanding their behaviours and the formation of their irrational beliefs from the members’ perspective. Workers can also develop strength among group members by appreciating and praising their pro-social behaviour. This can help them experience positive changes in their behaviour, build up trust with the workers and other group members and help motivate them to continuously make changes.

2. Patience

Workers should patiently listen to the sharing of each group member, especially the victims, who have poor self-expression and find it difficult to share. Workers should maintain patience and open-mindedness, giving the victims time to share their own experiences.

3. Awareness of workers’ own values

Workers should be sensitive to and aware of their own values, because the opinions and viewpoints shared by the group members may be different from their own. The workers may also find it difficult to believe or imagine the members’ experiences. Workers should not comment on the members’ unique experiences by expressing the thoughts of the general-public, even though they must help members understand the objective environment. The workers should be aware that they may have difficulty understanding and offering empathy, and they should discuss this with the assistant workers or supervisors to prevent their personal emotions from affecting the group intervention. Workers should reflect on the following points.

  • Their opinions of the group members: workers should not treat the members as wicked people who are difficult to cope with, but discover their strengths and weakness by understanding their personalities. Workers should offer appreciation for the members’ strengths and contributions. This helps to provide group members with a positive experience, encouraging them to improve themselves and develop their strengths.
  • Confronting conflicts: when adopting cognitive behavioural therapy, workers should explore the members’ irrational beliefs, confront their beliefs from different perspectives, dispute their irrational beliefs and help them reconstruct rational beliefs. Workers should continue to reflect on their own opinions of their conflicts with group members, when the members and workers have opposite points of view. During the process, members may feel they are losing recognition and find it difficult to face themselves and the workers. Moreover, they may even experience resistance and denial. Thus, workers should be good at analysing the members’ situations, be prepared to immediately provide responses and avoid conflicts. In addition, workers confrontations with group members should be positive, to address their irrational beliefs and help them reconstruct new beliefs.

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Counselling Skills
  1. Although group members are already classified as different types of aggressors and victims, the personalities, thoughts, emotions, behaviours and past experiences of individual members may vary. Workers should further understand the uniqueness and mindset of each member to precisely evaluate and intervene with them.
  2. Workers need to actively listen when disputing the irrational beliefs of group members, then select relevant points to be summarised and reframed as subjects for discussion. Workers should allow group members to debate whether the thoughts they express are reasonable and fair. During the debate process, workers should acknowledge the reasonable and fair arguments raised by group members and dispute any unreasonable or unfair arguments.
  3. Workers must listen actively to the group members’ sharing and offer appropriate responses, because every sentence may reflect their thoughts, inner values or anxieties. Appropriate and empathetic responses will help group members learn that the workers understand their thoughts, behaviours and feelings.
  4. When disputing the irrational beliefs of group members, the group must create pressure to force the members to inspect their thoughts and abandon their irrational beliefs. Workers can dispute unreasonable and unfair irrational beliefs under extreme circumstances. The aim is to broaden the group members’ thoughts through debate and enable them to learn how to think from different perspectives.
  5. The use of empathy in group interventions is extremely important to both aggressors and victims. During the first few sessions, workers can show empathy to build relationships with group members, reduce their defensiveness and increase their sense of belonging.
  6. Group members may feel uncomfortable and defensive when their irrational beliefs are questioned and challenged. Workers should help group members feel safe when attempting to change their irrational beliefs by designing group procedures. For instance, the individual’s name can be omitted when disputing a group member’s irrational beliefs.
  7. When group members are questioned and challenged, they may prevent workers and other group members from disputing their irrational beliefs by sharing positive viewpoints. Workers can use scaling questions to assess the extent of the change in the members’ thoughts, praise those who have broadened their personal thinking and let them know there is room for improvement.
Reactive Aggressor Group
  1. Workers must cope with group members’ different backgrounds and personalities. Reactive aggressors tend to have hostile attribution bias towards their surroundings, so they have a strong sense of self-protection. Based on our observations, female members physically attack others less than males, but they use more abusive verbal language or isolate others.
  2. At the beginning of the group, some members may display destructive behaviours to test the limits of the workers and other members. In such cases, the workers must construct an authoritative image and be fair to each member. Rules should be enacted so that members understand everything has a limitation, and they should be helped to develop a rational attitude.
  3. Because reactive aggressors are impulsive and easily provoked, the two workers in the group must prepare for and have a procedure in place for crisis intervention. There must be strong cooperation and a division of responsibilities. For example, one worker could be responsible for group content. The other could be responsible for observing the members’ reactions, motivating them to participate and handling unexpected incidents.
  4. Reactive aggressors are easily labelled as trouble makers, and they are rarely appreciated and complimented by others. Therefore, workers should encourage and compliment pro-social behaviour such as speaking politely, helping to clean up and assisting others. Providing these aggressors with a positive sense of achievement can result in positive changes to their behaviour, and they may be motivated to further change.
  5. Reactive aggressors have poor interpersonal relationships. Workers can use feedback from the other members to provide them with a positive peer experience and improve their social skills. However, workers must be careful to avoid some members’ provocations and criticism.
  6. Because the intervention is conducted in school, members may have conflicts outside the group and bring these problems back to the group. To avoid this, workers should frequently contact the teachers and school social workers to assess whether any members should be followed up with individually. The workers can consider the nature of the incidents and whether they need to discuss the scenarios. Real cases can easily influence the members and facilitate change.
Proactive Aggressor Group
  1. Members of the proactive aggressor group may share their own bullying experiences with the group, which may involve descriptions of their gang background or other violent behaviours. They may do this to enhance their personal status and reputation in the group and to create an authoritative image. If this situation occurs, workers should take measures to immediately intervene and state clearly that illegal behaviour is not allowed in the group. In this way other group members can be prevented from normalising such illegal behaviour. In addition, workers should pay attention to the group members’ emotions and observe whether they feel uncomfortable with sharing. If so, workers should immediately provide emotional support.
  2. Workers should also pay attention to the use of material rewards. In the initial stage of the group intervention, workers should utilise material rewards to enhance participation in group activities. At this stage, the members’ thoughts have yet to change and the material achievements are goals they can strive for. Nevertheless, workers should evaluate the effectiveness of using material rewards from time to time. In the mid-late or late stage of the group intervention, workers can use other means to reward the members, such as giving them cards of appreciation, or complimenting them. By this stage, the members have built up a relationship with the workers, and appreciation from both workers and other group members could be a needed encouragement. If workers only use material rewards to encourage members’ participation during the group sessions, it will influence the rewards’ effectiveness because members will become insensitive to them.
Aggressive Victim Group
  1. Aggressive victims lack self-confidence and a positive self-image. Therefore, workers should be specific when expressing appreciation of group members’ efforts and good performance. Workers should pay particular attention and provide appropriate feedback to quiet members when they express their opinions. Such attention will help these members feel that their participation and opinions are valued, and will encourage them to continue their active participation in the group.
  2. When designing and leading the group activities, it is important to ensure that members feel they have a choice. Workers should help group members understand that they can express their own opinions and that they are regaining control over their own lives. For instance, workers can design activities that encourage members to express their opinions and thoughts, so they can feel safe when expressing their opinions.
Pure Victim Group
  1. Because pure victims lack confidence, at the beginning of the group they participate as observers and avoid expressing their personal opinions and feelings. Therefore, workers should give them more opportunities to participate. In this way, the members will feel respected and have a sense of security. If necessary, workers can assign more team activities to reinforce trust and coherence among the members and encourage them to participate.
  2. Pure victims are sensitive to others’ comments. Therefore, before sharing sessions, workers should emphasise that there are no right or wrong opinions. This will build an atmosphere of mutual trust and tolerance. If the members feel embarrassed or rejected when sharing their experiences, workers can design discussions on similar topics so they can participate as third parties. Alternatively, workers can share their own experiences to reduce the members’ anxiety over self-disclosure.
  3. Because pure victims have low self-confidence, to increase their involvement in the group and foster improvement, workers should closely observe the members’ performance. In conjunction with this, they should immediately compliment the members to enhance their confidence. The workers can also learn about members’ successful experiences through homework assignments. Workers can use this method to increase the members’ confidence, especially those who are quiet.

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Application of Theories
  1. Workers should master the ‘ABC’ concept before starting a group, because group members can easily confuse events, beliefs and actions when sharing their own experiences. Workers should clarify the differences among group members to help them effectively challenge their irrational beliefs.

  2. Because the ‘ABC’ concept is relatively abstract, workers can make it more understandable by using real-life examples from school or the group members’ daily lives. Workers should explain the purpose and importance of learning this concept (e.g. helping the group understand that this is a way to know themselves better), to strengthen the members’ motivation to learn.

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Crisis Intervention

1. Aggressive behaviour among group members:
  • Because reactive aggressors easily experience fluctuating emotions, workers should pay more attention to the signs of their aggressive behaviour. In this way, physical conflicts among group members can be avoided. If possible, workers should talk to the aggressive individual and reiterate the group rules. The group members should be informed that aggressive behaviour is not allowed. They should be asked to follow and respect the rules, and made to feel they are being respected. Workers should evaluate each situation before deciding how to handle it.

  • It is important not to blame group members when handling incidents of aggression among reactive aggressors. It is more appropriate to examine the reasons behind the aggressive behaviour and manage the incident fairly.

  • Because proactive aggressors tend to be quite intelligent, workers should not criticise them in front of the other members, but instead send signals through eye contact or gestures. Similarly, at the end of the group, workers should talk to the aggressive individual and reiterate the group rules. The group members should be informed that aggressive behaviour is not allowed. They should be asked to follow and respect the rules, and made to feel they are being respected.

2. Interaction among group members:

  • If conflicts occur among group members before or outside the group, they may boycott each other during group sessions. This will affect interactions among the other members. Workers should handle such situations carefully to prevent the group from becoming a battleground for two opposing parties.

  • Group discussions are often arranged during group activities. Workers should evaluate each members’ character and interactions, and arrange small groups and members’ roles in accordance with the objectives of the activity. This will help to ensure that group members participate in the group and will enhance the effectiveness of the activities.

  • In proactive aggressor groups, group members may share their bullying experiences with others, which may involve illegal or other violent behaviours. They may do this to enhance their personal status, reputation or leadership in the group. At this moment, workers should immediately intervene and reiterate that illegal behaviours are not allowed, in case other members want to rationalise illegal or violent behaviours.

3. Distressed emotions among group members:

  • Some group members may feel distressed before coming to the group. For example, if passive victim group members have recently encountered bullying incidents, they may bring their negative emotions to the group. Therefore, workers should pay attention to any emotional changes among the group members and evaluate the risks and seriousness of relevant incidents to help the members manage their emotions and build rapport with the workers.

  • Group members may share their bullying experiences with the group. The responses of workers and other group members affect the bullied members’ trust in them. Therefore, workers should listen patiently and flexibly use emotional support to help the members, thus reinforcing coherence among them. Some victims in the group may have encountered domestic violence or other types of abuse. If they disclose such information, workers must listen carefully and pay attention to their emotions. Workers should provide immediate emotional support during the sharing, evaluate the level of risk and discuss whether the case should be followed up with the school social workers.

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Cooperation among Workers
  1. If two workers or more are leading a group, they should discuss the division of labour before starting so that they are clear about their job roles and can support each other during the sessions.
  2. Because the procedure for group activities is complicated, one worker may be responsible for leading them and the other may observe the members’ responses. When unexpected incidents occur, one of the workers should handle them, and the other should continue to lead the group and care for the other group members.

  3. Two workers can help group members feel a stronger sense of security within the group, and help reduce the members’ anxiety over being in a strange new environment. At the beginning, the workers should clearly inform the group of their respective roles. One worker should be responsible for training and leading the group; the other should be responsible for handling the members’ behavioural or emotional problems as an assistant. The assistant worker should also take on the role of observer during the group process and monitor the behaviour and performance of each member. At the end of each session, the assistant and leader should discuss the processes and counselling strategies used in the session and whether any improvements should be made to the group.

  4. Group members often need to be divided into small discussion groups during the sessions. If one of the members has more difficulty establishing relationships with others but finally builds up trust with one of the workers, that worker can lead the small group discussion this member participates in. This will help to engage the group member and enhance the therapeutic effectiveness of the group intervention.

  5. In the parent-child conjoint group, parents often ask about the performance and behaviours of their children. Workers should first show appreciation for their caring, then later the worker should reiterate the rule that each group member and worker must obey the principle of confidentiality. Additionally, the worker should encourage the parents to directly ask their children about their performance. This will help to facilitate parent-child communication. If the parents continue to inquire, the worker can provide a limited overview of their children’s participation in the group.

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Cooperation with Schools and Teachers
  1. If the workers leading the groups are employed by external organisations, it is important for them to establish close contact with the school. Establishing such contact helps the workers understand the school environment and the group members’ individual circumstances. This can be useful to workers when following-up on members. It also ensures that the school knows more about individual cases so it can cooperate with workers accordingly.
  2. Full cooperation and support from the school and teachers is required for successful group interventions. When the project is ongoing, teachers can encourage group members to actively participate in group activities and pay more attention to their performance in class. They can also help members feel cared for and supported.

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Arrangement of the Venue
  1. Regarding the seating arrangement, it is recommended that the seats be arranged in a semi-circle. Workers can sit or stand a few steps behind the centre of the semi-circle so that group members can see their faces. This facilitates group participation. If the seats are arranged in a circle, the workers may find it difficult to pay attention to the facial expressions of members sitting beside them. In turn, the members will only be able to see the side of the workers’ faces and thus will have less eye contact with them. These group members may easily feel neglected, which will reduce their sense of belonging to the group.
  2. Workers should be aware of the arrangement of the room and seating. Quiet rooms are preferred so that group members can feel free to share their own experiences and viewpoints. It is also recommended that miscellaneous objects and furniture be removed from the room, and that the seats not be close to the doors or windows. This will reduce the number of distractions and increase the members’ concentration.

  3. If possible, the group intervention should take place in a room that is close to the toilet, so that workers can easily monitor the situation when group members use it. It is also convenient for group members to calm themselves down in the toilet when they are agitated.

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Consideration of Group Selection

Child group intervention, parent group intervention, and parent-child conjoint group intervention all have their own advantages and features. Their great effectiveness has been proven in this project. Before selecting which of these group interventions to use, workers can consider the following points to meet the actual needs.

1. Time

Because students have different activities after school and both parents generally work in the daytime, it may not be easy to assemble different family members to participate in group activities. This situation is more common among grassroots families.

2. Manpower

We recommend that at least two workers be involved in child group intervention and parent group intervention. One worker would mainly be responsible for teaching the content and leading the discussion. The other would play the role of assistant, responsible for observing and recording the responses, attitudes and opinions of each participant. This arrangement should help the group proceed smoothly and also facilitate the collection of information. It should enhance the workers’ understanding of the students’ and parents’ opinions and help the workers deal with situations easily. Alternatively, parent-child conjoint group intervention involves both the parents and students, and these two groups often need to have separate activities. Thus, this type of group intervention demands more human resources and should involve at least three workers during the interventions.

3. Participants

Cognitive behavioural therapy requires students to have a certain degree of cognitive and reflective ability. Therefore, some students may be limited by their age or cognitive development, and they may not be good candidates to receive it. It is more appropriate to provide parent group intervention or parent-child conjoint intervention to younger students.

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© 2019 City University of Hong Kong          Project on Children and Adolescents at Risk Education (Project C.A.R.E.)