ESEARCH

Experiences in Online Process Groups: A Qualitative Study

Kelly A. Kozlowski Courtney M. Holmes

Bowling Green State University

Online group counseling is an area scant with research, as much investigation has focused on the provision of online individual counseling services. During the course of an academic year, 12 master’s-level counseling students participated in 2 online (videoconferencing) process groups. The purpose of this phenomenological study was to gain insight into members’ experiences in online counseling groups. Several themes were identified, including the linear nature of the group, superficial engage- ment within the group, and feeling disconnected from one another. Limitations and implications are discussed.

Keywords: counselor training; online group counseling; technology; video- conferencing

The vast majority of what the field understands about group counsel- ing has been learned from groups that take place in face-to-face group environments. The current literature includes research that informs group counselors about the experiences of group members in face-to- face groups, such as the experience of interpersonal and intrapersonal processes in groups (Arnd-Caddigan, 2012; Corey, Corey, & Corey, 2014; Crane-Okada, 2012; Gladding, 2012; Krug, 2009). Currently, a gap exists in the literature concerning the experiences of members in online counseling groups. This qualitative study utilized phenomenological research methods to understand the essence of members’ experiences in online counseling groups.

The Best Practices Guidelines published by the Association for Specialists in Group Work (ASGW) state, “Group workers are aware of and responsive to technological changes as they affect society and

Manuscript submitted December 16, 2013; final revision accepted July 21, 2014. Kelly A. Kozlowski, Ph.D., and Courtney M. Holmes, Ph.D., are assistant professors in the Department of Mental Health and School Counseling at Bowling Green State University. Correspondence concerning this article should be addressed to Kelly A. Kozlowski, Department of Mental Health and School Counseling, Bowling Green State University, 451 Education Building, Bowling Green, OH 43402. E-mail: kkozlow@bgsu.edu

THE JOURNAL FOR SPECIALISTS IN GROUP WORK, Vol. 39 No. 4, December 2014, 276–300 DOI: 10.1080/01933922.2014.948235 © 2014 ASGW

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the profession” (ASGW, 2007, p. 115, A.9). Several studies (King et al., 2009; Meier, Lyons, Frydman, Forlenza, & Rimer, 2007) investigated the efficacy and utility of using technology for group and family coun- seling, although the literature base is limited. Client perceptions of the use of online groups have been found to be generally positive due to the convenience of this environment (King et al., 2009). In addition, research has found that client outcomes in videoconferencing groups are comparable to face-to-face group outcomes (King et al., 2009). What is still unclear is whether group members in online environments expe- rience the curative nature of groups in a similar way as members of face-to-face counseling groups.

Online Counseling

Digital connections have become increasingly common in the field of counseling. The provision of digital services includes a variety of modalities including, but not limited to, information-based websites, interactive computer programs, asynchronous correspondence (e.g., email), synchronous chat (e.g., instant messaging), and videoconferenc- ing (Barak & Grohol, 2011). Many providers are offering these digital services as supplemental options for face-to-face services, or as stand- alone modalities (Menon & Rubin, 2011). Most often, these digital types of services are provided in an individual counseling format (Finn & Barak, 2010).

While online group therapy is not used as frequently as individ- ual online therapy (Bellafiore, Colon, & Rosenberg, 2003), particular modalities (audio or text based online counseling) are popular as a means to provide group services including online, mutual self-help groups, support groups, and online blogs. These services are most often interventions offered online by individuals who are untrained in coun- seling skills but are peers within the digital community. These services provide space for individuals to express themselves and for individuals to find help, peer support, ideas, and validation (Barak & Grohol, 2011; Meier et al., 2007). Additionally, research has suggested the effective- ness of online, text-based support groups for adults and teens (Meier et al., 2007; Webb, Burns, & Collin, 2008). However, some researchers have proposed that an unknown necessary component of therapeutic work is missing from online support/self-help groups and that these types of group modalities may not be thoroughly meeting the needs of those involved (Barak & Dolev-Cohen, 2006; Freeman, Barker, & Pistrang, 2008; Meier et al., 2007).

Online Group Counseling

Many types of groups exist for a myriad of different purposes. Psychoeduational groups focus on members’ cognitive, affective, and

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behavioral skills through the use of structured, educational procedures. Counseling groups focus on interpersonal processes to help members resolve difficult problems of living, including career, educational, and personal concerns. Therapy groups address psychological problems of members with acute chronic mental or emotional problems that have lead to impairment in functioning. Another example is support groups, which consist of members with similar concerns who help each other examine personal issues and together find ways to cope more effec- tively with these issues. Support groups are not always lead by trained counselors.

Counseling groups are a foundational part of the mental health pro- fessions (Corey et al., 2014; Gladding, 2012). One way to offer online process groups is through videoconferencing (synchronous chat using video and audio). Studies point to the effectiveness of videoconfer- encing when treating individual clients dealing with issues such as anxiety and depression (Dunstan & Tooth, 2012), clients with psychosis (Sharp, Kobak, & Osman, 2011), and adolescents (Sefi & Hanley, 2012); however, little is known about using videoconferencing with groups.

Some research has been done into the efficacy of online support groups (Barak & Dolev-Cohen, 2006; Darcy & Dooley, 2007; Freeman et al., 2008; Haug, Strauss, Gallas, & Kordy, 2008; Lieberman et al., 2010; Webb et al., 2008; White & Dorman, 2001). Additionally, research has been done regarding specific outcome-based groups (Greene et al., 2010; King et al., 2009; Marziali, 2006). What have not yet been inves- tigated are the experiences of members in online groups, particularly online groups that require high levels of interpersonal connections. As such, it is unknown if an online modality can create an environment in which interpersonal relationships or therapeutic conditions can be established.

King et al. (2009) compared the outcomes of clients diagnosed with substance abuse disorders who participated in either face-to- face groups or videoconferencing intense substance abuse treatment groups. The results showed that 100% of respondents in the online group reported a strong preference for that type of group over face- to-face groups citing reasons such as social anxiety and lack of access to childcare impeding their ability to make face-to-face meetings (King et al., 2009). Additionally, no significant difference was found in effi- cacy of the treatment conditions showing that both types of groups were equally effective in supporting client change (King et al., 2009). Gilkey, Carey, and Wade (2009) studied a videoconferencing interven- tion for families with children with traumatic brain injury in which the therapist used videoconferencing to meet with the family once a week for several weeks. Even though the therapist was the only one using videoconferencing to meet with the family remotely, the results indicated mixed responses as to preference of the videoconferencing

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option when compared with a face-to-face option. Nearly the same amount of adult caregivers, identified client children, and siblings identified preference for videoconferencing as those who identified pref- erence for face-to-face counseling. However, the majority of participants identified videoconferencing as either “very” or “extremely” helpful overall. Gilkey et al. (2009) noted many challenges to successful thera- peutic videoconferencing interventions including low levels of: (1) client knowledge and comfort with technology; (2) client readiness to address problems; and (3) personal flexibility to deal with imperfections of the videoconferencing modality and technology in general.

Curative Factors in Group and the Leader’s Role

Yalom, Tinklenbery, and Gilula (1968) describe several curative or therapeutic factors of group counseling including: universality, altru- ism, instillation of hope, cohesiveness, existential factors, interper- sonal learning, self-understanding, and catharsis. Additionally, client healing occurs as part of interpersonal and intrapersonal process of counseling groups (Arnd-Caddigan, 2012; Corey et al., 2014; Crane- Okada, 2012; Gladding, 2012; Krug, 2009). Finally, safety and trust are paramount to the success of counseling groups, as these characteristics are established, groups progress through several stages from forming to termination (Corey et al., 2014; Crane-Okada, 2012).

In a qualitative study about the experiences of master’s-level coun- selors who participated in a semester-long, face-to-face process group, Luke and Kiweewa (2010) found several important themes concern- ing the experiences within the group process including genuineness, authenticity, active participation, and safety. These themes were described as being important to the participants’ personal growth and awareness within the group. The curative factors and efficacy of tra- ditional, face-to-face group work is well documented (e.g., Corey et al., 2014; Dierick & Lietaer, 2008; Krug, 2009; Yalom & Leszcz, 2005).

The ASGW Best Practices Guidelines offers suggestions and rec- ommendations to direct group counselors’ performance of group coun- seling (ASGW, 2007) as these guidelines state, “it is incumbent upon Group Workers to give considerable attention to the intent and context of their actions” (ASGW, 2007, p. 112). Additionally, the competencies state that group workers should possess a “basic knowledge of groups and the principles of group dynamics” (ASGW, 2007, p. 115) which includes managing the therapeutic conditions inherent within group counseling (ASGW, 2007, B.4). As the context of counseling shifts to incorporate technology, group workers’ should understand the chal- lenges and opportunities that videoconferencing and other online forms of group counseling present.

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However, it is currently unknown if curative factors of face-to-face group counseling are transferable to counseling groups that are lead in a virtual, or online, environment and if online group counseling can produce qualities, processes, or environments that are similar to face-to-face groups. The complexity of synchronous counseling groups, including the ability of such group to create therapeutic conditions is fertile ground for continued research. In an effort to address this liter- ature gap, the current study investigated the experiences of members in online counseling process groups and asked the following research question: What was what is it like to experience group counseling in an online environment?

METHOD

The purpose of this study was to understand the shared experiences of members of online counseling groups. Based on Saltmarsh, Jenkins, and Fisher’s (1986) Task, Relating, Acquiring and Contacting (TRAC) model of group work which organizes the various types of groups based on the levels of processes and management, the authors chose to study contacting groups, specifically counseling groups based on the group’s need for high levels of counselor facilitation and process. The terms “process groups” and “counseling groups” will be used throughout this article to identify the nature of the studied group. Members understood the group would be a counseling group and their participation would require personal engagement with the process. Members also under- stood that each would set individual goals and take turns rotating into the leadership role. When members were leading they understood they were responsible for facilitating group safety, and monitoring interper- sonal and intrapersonal interactions. Participants were familiar with leading groups as well as with the concept of leadership rotation, as they had previously taken the semester-long Group Counseling course, which contained training in rotating leadership.

The authors utilized a constructivist theoretical framework to guide their research as “findings are literally created as the investigation pro- ceeds . . . and individual constructions can be elicited and refined only through interaction between and among investigator and respondent” (Guba & Lincoln, 1994, p. 111). Within the constructivist framework, the researchers used a transcendental phenomenological approach to qualitative research to capture a deeper level of understanding in which researchers come into contact with the lived experiences of par- ticipants. Through this approach researchers attempt to more deeply understand the essence of and complex ideas that surround such expe- riences (Bowen, 2008; Lichtman, 2013). The researchers, “sought to understand the individual and the collective experiences . . . and how

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participants’ intentionally and consciously (thought) about their expe- rience” (Hays & Wood, 2011, p. 291). Additionally, phenomenological studies seek to develop training practices and policies around the studied experience (Creswell, 2013).

Participants