Leader Strategies in Managing Maladaptive Group Behavior: An Empirical Report from School-Based Groups in A RCT

Purpose. Group therapy is a widely used modality in the treatment of AOD problems and most studies report beneficial effects. However, studies have reported that aggregating youth with conduct problems created environments in which youths exhibited negative behavior that was positively reinforced by other group members (i.e., "deviancy training"), producing iatrogenic effects. Within schools where adolescents may already know each other, there may be special concerns about aggregating youths with conduct and AOD problems. This presentation reports on an exploratory/developmental study funded by NIAAA (R21 AA015679-01) called Group Enhancement for Teens in Treatment (GET-IT), which examined the influence of group composition (i.e., proportion of conduct problems among group members), maladaptive behavior in group (i.e., antisocial behavior and its reinforcement), and group leader behaviors in response to maladaptive behavior in group, on AOD outcomes. This presentation will 1) Describe leader responses to maladaptive group behavior (MGB); 2) Identify responses which had the most immediate beneficial effect on MGB and those which had no immediate effect; and 3) discuss leader responses in groups with stronger and weaker AOD outcomes.

Methods. Data are from a NIAAA clinical trial involving 120 youths randomly assigned to 20 groups using the Westchester Model Student Assistance Program protocol. In this new study, multiple evaluators reviewed audio tapes and transcripts of group sessions to identify every instance of maladaptive behavior in groups and leader responses to the maladaptive behavior. In this presentation, we present data about leader responses to MGB. Using a coding scheme developed from several instruments on group leadership that define leader behaviors as “positive” and “negative,” coders identified each leader response to MGB and also identified whether there was a beneficial effect on the group moments later as a result of the group leader response.

Results. There were 19 closed groups (13 middle school; 6 high school) involving 16 single-led groups and 3 with co-leaders (6 leaders in total). Overall, there were 3,824 incidents of MGB across the 19 groups. There were more “positive” than “negative” leader responses (56% vs. 44%, respectively). Positive leader responses had a much higher likelihood of immediate beneficial effects than negative leader responses. The specific leader behaviors “extinguishing” and “interpreting” had the most immediate beneficial effects. In the poorest performing groups (with respect to amount of maladaptive group behavior and AOD outcomes) leader responses overwhelmingly had no beneficial effect.

Implications. Leader behaviors are an essential ingredient in well-functioning groups. In this study, specific leader actions appeared to contribute to toxic group environments in which much time was spent on managing group behaviors. There were numerous incidents of MGB in these groups that were manualized and structured. In particular, the poorest performing groups can be frustrating to group workers who lack the skills to intervene. Leaders should be taught how to manage MGB effectively using positive leader responses. The presentation is expected to stimulate discussion about what constitutes effective group leader interventions in adolescent AOD groups.