3. Authors:
Tsvi E. Gil, B. Sc., M. A.,
Graciela Karmon, M. D.,
and Latiff group work team
Society for advancement of health
services
4. Team members are…
Mahmud Asla, Ph. D.
Faten Egbaria, B. S. W.
Ibrahim Igbariy, M. A.
Kresteen Iskander, B, S. W., M. A.
Mansur Mihdawi, B. S. W.
Amany Saady, M. A.
9. Our clients
Palestinian children (ages 6 – 18),
Living in Northern Israel,
Suffering of all kinds of
psychopathologies, as well as
psychosocial mishaps
10. Our staff
3 psychologists
4 social workers
2 secretaries -
all of them Palestinians!
11. …and
Director (psychiatrist) and supervising
personnel (psychologists)- all of them
Jewish!
(and not speaking Arabic)
14. So… we started initiating
therapeutic groups
Groups for children according to age
groups
Groups for children according to
diagnoses or classes of problems
Groups for parents
15. Obstacles for creating groups:
Staff not trained in group work
Staff sees group work as ‘second best’
Fear of failure
Unrewarding previous experience
Busy with ongoing treatments
Anxiety in face of the unknown – uncertainty,
lack of control, lack of knowledge,
undefinability of goals (structured vs. open
groups)
16. .. And target populations:
Expect individual treatment, see group
work as ‘second best’
Fear of disclosure and contagion
Difficulties in gathering together at
particular timing
17. Principles of Group Work with Children
(Z. Shechtman – Group Counseling and Psychotherapy with
Children and Adolescents)
Experiencing as a major mechanism of
change (Greenberg)
Exploration, Insight, Action (Hill)
Vicarious learning, role flexibility, universality,
altruism, family reenactment, interpersonal
learning (Fuhriman & Burlingame)
Self disclosure and mutual support (Spiegel &
Classen)
18. Therapeutic factors in children’s groups
(Z. Shechtman – Group Counseling and Psychotherapy with
Children and Adolescents)
Group cohesion, catharsis, interpersonal
learning (Fuhriman et al)
Support, self-disclosure (Lieberman & Golant)
Awareness, relationship, focus on others,
problem definition (Kivlighan et al)
Positive group climate (Riva & Haub)
20. Group therapist does…
Initiates
Encourages
Directs
Questions
Informs
Paraphrases
Being patient (tolerant)
and gives feedback
21. What is unique in working
with Palestinian population?
Holidays (olive harvest, Ramadan,
pilgrimage, Muhammad birthday,
Easter, Land Day, wedding).
A large catchment area with poor level
of public transportation, lack of
resources for arrival
Anger and violence in closer and
distant surroundings
22. violence
Violence inside the family
Violence in the culture
Accidents
Violence in the Israeli society
Violence between Israeli and Palestinians
Violence anger and anxiety
conflicts, distress, and misconducts
23. The war in Gaza Strip (December
27th 2008 – January 17n 2009)
24. Phenomena in parent groups:
Traditional and patriarchal families
Minor paternal involvement in child
upbringing, due to traditional familial
values
Involvement of the larger family
Pseudo-adoption
25. Phenomena in working with
parents:
Idealization of childhood – jammed in
traditional familial patterns
Conflicts with sexuality, e.g. – value of
virginity, rejection of homosexuality
Men work and find it difficult to participate in
parents group
Manish roles of men (e.g., men do not touch
or cry)
26. Palestinians – society in
transition
Laws, rules, and norms – change and are not clear-cut
Influence of Israeli and global societies
Influence of religious and fundamental values (Sunnis and
Shiite)
Vague boundaries between individuals and their family and
community
Conflict between women’s individual needs and their role in the
family
Individual is dependent on family and community
Difficulties in contact with Israeli society
Conflicts in national identity (Israeli, Arabic, Palestinians,
Muslims)
27. Collectivist Society (M. Dwairy)
Source of psychopathology – intra-psychic vs.
interpersonal
Aim of psychotherapy – strengthening the
self vs. adaptation to societal values and
requirements
Adjustment to family and society vs.
individuation and autonomy
Treatment as individual parade vs. treatment
as part of the community
28. Group leaders as social
change agents
Parent groups proved to contribute to
alterations in family roles: men give up
hierarchical superiority in favor of
proven investments and achievements;
women take inner locus of control
Empowerment of women in their
families
29. Individual problems reflect
society conflicts:
Identity in a transitional society
Doubt and uncertainty in the community lead
to conflicts and confusion in the individual
Violence in the surrounding leads to fear and
anxiety in the family and individual, leading to
psychopathology
Intrapsychic anxieties reflecting community
fears: Palestinians in occupied territories,
Rightists’ demonstrations
30. Research and findings
Difficulties in harness staff to scientific
missions
Difficulties in eliciting valid reports from
participants
Difficulties in budgeting of research
Evidence for significant underlying
processes take place with participants
31. Literature cited
Dwairy M. – Toward psycho-cultural approach in muddle eastern societies. Clinical psychology Review 19: 909-915, 1999.
Dwairy M. – Foundations of psychosocial dynamic personality theory of collective people. Clinical Psychology Review 22:
343-360, 2002.
Fuhriman S. G. & Burlingame G. M. – Consistency of matters: a comparative analysis of individual and group process variables.
Counseling Psychologist 18: 6-63, 1990.
Fuhriman A. et al – Validating a behavioral measure of catharsis, cohesion, and insight, in group therapy. Ann. Conf. Soc.
Psychotherapy Res., Braga, Portugal, 1999.
Greenberg L. S. – Emotion-Focused Therapy. Washington, D. C., American Psychological Association, 2002.
Hill C. E. – Helping Skills: Facilitating exploration, insight, and action. Washington, D. C., American Psychological Association, 2nd.
Ed., 2005.
Kivilghan D. M., Multon K. D., & Brossat D. F. – Helpful impacts in group counseling: development of multidimensional rating
system. Journal of Counseling Psychology 43: 347-355, 1996.
Lieberman M. A. & Golant M., Leader behavior as perceived by cancer patients in professionally directed support groups and
outcomes. Group Dynamics: Theory, Research, and Practice 6: 267-276, 2002.
Riva M. T. & Haub A. L. – Group counseling in the schools. In J. L. de Lucia-Waack et al (eds.) – Handbook of Group Counseling
and Psychotherapy. Thousand Oaks, Ca, Sage,, 2004, pp. 309-321.
Schechtman Z. – Group Counseling and Psychotherapy With Children and Adolescents. Mahwah, N. J., and London, Lawrence
Erlbaum, 2007.
Spiegel D. & Classen C., Group Therapy for Cancer Patients. New-York: Basic Books, 2000.
32. We say good-bye and thank
you…
Our mission had not finished yet!