Small Group Counseling

Missouri Comprehensive Guidance ProgramResponsive Services
Small Group Counseling Module

Page 1 of 43 SmallGroupCounseling.doc
Missouri Comprehensive Guidance Programs: Linking School Success With Life Success
COMPREHENSIVE GUIDANCE PROGRAM

RESPONSIVE SERVICES:
SMALL GROUP COUNSELING MODULE

A Professional School Counselors Guide to
Planning, Implementing & Evaluating
School-Based Counseling Groups

DEVELOPED BY PROFESSIONAL SCHOOL COUNSELORS
FOR PROFESSIONAL SCHOOL COUNSELORS

WITH SUPPORT FROM
THE MISSOURI DEPARTMENT OF ELEMENTARY & SECONDARY
EDUCATION
&
THE MISSOURI CENTER FOR CAREER EDUCATION

Missouri Comprehensive Guidance Programs:
Linking School Success With Life Success
Page 2 of 43

MISSOURI COMPREHENSIVE GUIDANCE PROGRAM
RESPONSIVE SERVICES COMPONENT:
SMALL GROUP COUNSELING MODULE

TABLE OF CONTENTS

Introduction ... 3

Part 1: Overview ....................................................................................................................... 4

Part 2: Review .......................................................................................................................... 5

Part 3: Organizing ..................................................................................................................... 9

Documents for Small Group Counseling Module: ................................................................... 12

Document 1: Small Group Counseling: Information for School Personnel ......................................... 13

Document 2: Small Group Counseling: Needs Assessment/Student Referral Forms (Samples) ......... 15

Document 3: Small Group Counseling: Assessment of Students Perceived Needs ........................... 18

Document 4: Small Group Counseling: Student Behavior Rating Form ............................................. 19

Document 5: Small Group Counseling: Action Plan Template ........................................................... 20

Document 6: Small Group Counseling: Screening/Selection Procedures .......................................... 21

Document 7: Small Group Counseling: Informed Consent Forms ...................................................... 24

Document 8: Small Group Counseling: Guidelines/Ground Rules. .................................................... 26

Document 9: Small Group Counseling: Student Passes (samples) .................................................... 27

Document 10: Small Group Counseling: Unit Template ...................................................................... 30

Document 11: Small Group Counseling: Group Session Template ..................................................... 31

Document 12: Small Group Counseling: Group Session Follow-up Form .......................................... 32

Document 13: Small Group Counseling: Student Post-Group Follow-Up Interview Form .................... 33

Document 14: Small Group Counseling: Teacher Pre/Post-Group Perception Form (2 Samples) ......... 34

Document 15: Small Group Counseling: Parent/Guardian Post-Group Perception Form ..................... 36

Document 16: Small Group Counseling: Student Post-Group Perception Form ................................. 38

Part 4: Small Group Counseling: Resources ...................................................................... 40

Part 5: Small Group Counseling: Sample Units and Sessions ........................................... 42
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RESPONSIVE SERVICES: SMALL GROUP COUNSELING MODULE

Introduction
The content of the Missouri Comprehensive Guidance Program (MCGP) is based on the Comprehensive
Guidance Curriculum Framework which includes Personal/Social Development, Academic Development
and Career Development. The framework guides all program activities and follows the premise that
student competency in the strands strengthens student achievement. Learning in these strands
complements learning in other core curriculum areas.

The MCGP Responsive Services Component provides direction for responding to needs within the
school community. Those needs include school, community, state, or national crisis/emergency
situations as well as individual circumstances that require a response. Professional School Counselors
(PSCs) may work with students as a part of the districts emergency management plan. PSCs may work
with students individually or in groups. In some situations, it may be necessary for an individual student
to be referred for outside counseling.

The following Responsive Services modules are available: Individual Counseling, Small Group
Counseling, School-Wide Emergency Management; and Referral Policies, Processes, and Procedures.
All materials are available via the DESE Missouri Comprehensive Guidance eLearning Center on the
Missouri Center for Career Education (MCCE) website.
(http://missouricareereducation.org/curr/cmd/guidanceplacementG/elearning/)

Part 1: Overview of the Module for School-based Small Group Work: An explanation of how
small group counseling fits within the Responsive Services Component of Missouri
Comprehensive Guidance Program (MCGP).
Part 2: Review of School Based Small Group Work: Key factors to consider when working with
students in small groups.
Part 3: Organizing the Small Group Counseling Experience: A step-by-step guide to planning,
implementing, and evaluating small groups. Included are forms, documents, and
informational materials to assist in the implementation of each step.
Part 4: Small Group Counseling Resources. This section contains print and electronic materials
for facilitating small groups.
Part 5: Sample Small Group Counseling Units and Sessions: Examples of topic-specific small
group counseling strategies. The sample Units and Sessions provide structured small
group counseling experiences addressing 15 topics of relevance to K-12 students in the
three strands of the Comprehensive Guidance Program: Personal/Social, Academic and
Career Development: The following table lists the units and sessions available for each
level.

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The Missouri Comprehensive Guidance Program
Responsive Services: Small Group Counseling

PART 1: OVERVIEW

The Responsive Services Component of the MCGP provides for targeted assistance for those students
who are not achieving their potential. Working with students in small groups is one strategy for helping
students become more successful. Students who will benefit from working with the Professional School
Counselor (PSC) in small groups may come to the attention of the PSC through observations during
classroom guidance activities, self-referral, or referral by parents, teachers, and peers.

Small group counseling units and sessions address topics related to personal/social, academic and
career development. The ultimate goal of small group counseling is to provide students with the
opportunity to learn more about and work through such things as interpersonal issues, to develop
strategies and skills to positively impact their school achievement and to increase appropriate social
interaction skills.

Table 1: Topics of Sample Small Counseling Group Units and Sessions

STRAND:PERSONAL AND SOCIAL DEVELOPMENT
Units/Sessions: Personal and Social Development
Pre-K-Grade 2 Grades 3-5 Middle School (6-8) High School (9-12)
Anger Management Anger Management Anger Management Anger Management
Family Changes Family Changes Loss/Grief/Divorce Grief
Conflict Resolution Conflict Resolution Healthy Relationships
Self Control Self Control
Grief Grief
Friendship Friendship
STRAND: ACADEMIC DEVELOPMENT
Units/Sessions: Academic Development
Study Skills Study Skills Study Skills/Organization Tools for Success
Homework New Student
STRAND: CAREER DEVELOPMENT
Units/Sessions: Career Development
Self-Esteem Self-Esteem Career/Transition Personal Planning
Senior Decision Time

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PART 2: REVIEW

Types of Groups: ASGW WEBSITE
The Association for Specialists in Group Work (ASGW) has defined four types of groups:

Task Groups: application of group strategies that promote the accomplishment of group tasks and
goals, e.g., curriculum development, developing individual educational or social learning plans.
Psycho-educational Groups: application of group strategies that promote typical growth and/or
prevent/remediate transitory difficulties in personal/social, academic, career development
Counseling Groups: application of group strategies to address problems of living that arise in the
lives of students
Psychotherapy Groups: application of group strategies to address consistent patterns of
dysfunctional behaviors and/or distortions.

Psycho-educational and Counseling Groups are the types of groups addressed by the Responsive
Services Small Group Counseling Module.

Format Considerations for School-Based Groups
Structured vs. Unstructured Groups:
Small groups may be structured or unstructured. School-based groups usually follow a structured
format; the units/sessions in Part 4 of the Small Group Counseling Module provide samples of
structured groups.
Structured groups are time-limited. They are scheduled for a specified number of sessions, focus
on a single topic, follow a pre-established agenda, and membership is closed. The structure is
pre-set; students provide the content based on their experiences with the topic and the changes
they wish to make in their lives.
Unstructured groups may or may not have a pre-set topic or agenda; the counselor applies a broad
range of techniques to facilitate the process of the group. The groups are usually on-going with
no set begin/end date and membership is open. Unstructured groups require advanced group
leadership skills.

Number of Sessions/Length of Sessions/Scheduling:
The number, length and scheduling of small group counseling sessions will be determined by the
parameters of the school setting. In general, the following guidelines will apply:
Number of sessions:
Typically six to eight
Length of sessions will depend upon:
Developmental level/attention span of participants
Schedule of the school
Flexibility of students schedules
Factors to consider when scheduling groups
Consult with classroom teachers to establish times for groups
Avoid recess/lunch times if possible (all students need unstructured-time and exercise)
Rotate meeting times so that students do not miss the same subject every time
Note: The following section serves as a reminder of the elements of school-based small group
counseling. Refer to the group work textbooks you used in your counselor education program for
more detailed information. In addition, you are encouraged to read current small group counseling
literature (see Part 4: Resources).
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Group Composition:
Group composition refers to the number and characteristics of participants.
Heterogeneous groups:
Participants have different needs/problems
Develop more slowly and tend to be less cohesive
Homogeneous groups
Participants have same or similar needs/problems
Develop more quickly and tend to be more cohesive
Group Size
Recommended group size ranges from 6-10 participants

Structure/Composition of School-Based Groups:
The structure and composition of school-based groups will be determined by the needs of students;
however most school-based small groups are:

Structured in nature (pre-set structure/strategies designed to address a specific topic)
Homogeneous in terms of participant issues
Homogeneous with respect to the ability to participate in the task and goals of the group
Heterogeneous in terms of personal characteristics

General Guidelines
Screening and Selection of Group Members:
Screening of members is essential
Some students are not ready/able/willing to adhere to the norms/expectations of group work
Seek alternative interventions to meet the needs of students who are not selected
Strive for:
Role Models: each group has at least one positive role model
Age difference: no more than two years difference in ages
Diversity: include students who have different backgrounds and perspectives
Gender: include both sexes unless topic or developmental levels indicate same-sex group would
be more effective
Compatibility: seek participants who are willing to work with others
Avoid:
Placing siblings or close relatives in the same group
*Selecting students with behavioral histories that could interfere with the groups benefits to
other members, e.g., extreme aggression or extreme shyness, deep hostility or
destructiveness
*Selecting students who have experienced recent trauma or crisis (unless the trauma or crisis is
the focus of the group)

*These students needs should be met by another type of intervention
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Group Dynamics: The Stages
Groups have a life of their own, but the stages of a group are predictable.
Stage 1 Getting acquainted/setting norms/building trust: Participants find their places and grow to
trust themselves, each other and the leader. Psychological safety and connections are two keys
to building trust. Conflict may precede trust, which may be demonstrated by acting-out or testing
the leader as part of the process in the first stage. Stage 1 is sometimes called the
Storming/Norming Stage.
Stage 2 Working together to accomplish individual and group goals. Two keys to accomplishing
goals are valuing self and others, and believing the group will make a difference. Cohesiveness
and productivity have been established. Stage 2 is sometimes called the Performing Stage.
Stage 3 Ending the Group: Closure is attained by reflecting on individual and group
accomplishments. Plans for future growth are enhanced by projecting independent application of
knowledge and skills gained as well as identifying supports to sustain changes. Stage 3 is
sometimes called the Mourning Stage because the group members mourn the loss of the group.

The PSCs leadership responsibilities include:
Facilitating group progress from stage to stage
Understanding the importance of each stage of group development
Protecting and promoting group members psychological safety, privacy, and trust

Group Dynamics: Group Norms
There are two types of expectations regarding the interaction of the members and the leader:
Explicit: leader, with members, define specific rules and guidelines
Implicit: unwritten rules or patterns that develop into expectations

The PSCs leadership responsibility includes:
Acting as the reinforcing agent charged with setting up and maintaining group norms
Modeling group norms

Conducting the Sessions
Attending to whats happening within the group both overtly and covertly
Processing activities and interpersonal interactions
Modeling behaviors

The First Session:
This is the most important session, when group members either buy-in or opt-out.

Developing mutual understanding of confidentiality: group members understand that
confidentiality cannot be guaranteed, even though it is an expectation
Reviewing the purpose and individual goals of the group
Helping group members determine changes they want to create in their lives
Encouraging dialogue among group members
Discussing voluntary participation, policies and procedures
Ensuring individual group members gain knowledge, skills and strategies: connection with
peers, identifying with the issue, and a sense of belonging
Establishing the expectation that group members will be completing homework outside of the
group setting
Processing the experience: What was group like for you? What did you learn about yourself?

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The Middle Sessions:
The trust and safety of group members is maintained.

Reviewing confidentiality and ground rules
Checking-in with each group member
Introducing each sessions purpose
Relating new content to past content and improvements group members are experiencing
Processing session and work for next session
Preparing for end-of-group issues

The Last Session:
Group members decide how to apply the skills and information they have learned during the group
process.

Reviewing confidentiality: Reinforce that it must continue after the group ends
Resisting the temptation to continue group sessions
Planning time to process: Make a plan for continuation of newly learned skills

Saying good-bye to group members: Plan carefully for processing because there may be a
temptation to minimize the importance of this process. Remember that, even though group members
will continue to see each other, they are saying good-bye to the dynamic that made the group
meaningful for them.
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PART 3: ORGANIZING

This section of the Small Group Counseling Module provides steps for planning, implementing, and
evaluating small group experiences for students at all levels. Sample documents are included. It is
important to modify these documents to meet the needs and policies of your district.

The following steps will be helpful when organizing for small group work:

STEP 1. Conduct Survey to Assess Small Group Counseling Needs and Identify Potential
Group Members: The purpose of a needs assessment is to determine group topics that will
benefit students. Three kinds of surveys will help identify group topics:
1. Teacher/staff surveys to assess their perceptions of student needs
2. Student surveys to assess perceptions of their needs
3. The Missouri Comprehensive Guidance Program (MCGP) Needs Assessment (See
MCGP Manual).

When needs have been identified, teachers and other school staff are surveyed to identify
students who would benefit from participating in the groups. These hyperlinked documents will
assist you in the small group membership selection process.

Document 1: Small Group Counseling: Information for School Personnel
Document 2: Small Group Counseling: Needs Assessment/Student Referral Forms
Document 3: Small Group Counseling: Assessment of Students Perceived Needs
Document 4: Small Group Counseling Student Behavior Rating Form

STEP 2. Develop Topic-Specific Small Group Counseling Action Plan: Develop a small group
action plan for each group. The Action Plan includes detailed information concerning the group:
description, purpose, rationale, objectives, logistics, risks and safety issues, implementation
procedures, and evaluation. The Action Plan puts in writing the subtle considerations of the
specific group; the PSC uses the plan to guide development and/or selection of units and
sessions. The Action Plan is also an informational document for supervisors and others who may
have questions about school-based small group counseling.

Document 5: Small Group Counseling Action Plan Template

STEP 3. Publicity: Disseminate information about the small groups to various audiences (e.g.,
teachers, administrators, parents, counselors, students, custodians, bus drivers, school nurse).
Methods of communication may include daily announcements, flyers, newsletters, personal
invitations, e-mails, and/or website postings. Information and forms may also be distributed and
completed at faculty meetings, made available in teacher workroom, faculty lounges, placed in
teacher mailboxes, or placed on the district website. See links in Step 1.

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STEP 4. Conduct Pre-Group Interview/Screening: This process informs the student of the
purpose of small group counseling, assesses the students readiness and level of interest in
group participation and helps determine group membership. Pre-group screening interviews are
critical and should be conducted on an individual basis.

The purposes of the group screening process include:
Informing students about the group
o Describe the group.
o Tell students what they may gain from being in the group.
o Tell students about group expectations, including participation and confidentiality.
o Inform students of alternatives if they are not selected for the group
Gauging students level of interest and commitment
o Ask students if they are willing to follow expectations and ground rules.
o Ask students to rate their level of interest.
Selecting participants
o Is the student a willing participant?
o Hypothesize whether the student will be satisfied with
Group focus as it relates to personal needs and goals
Other members of the group
The process of working in a group

STEP 5. Select Group Members: The screening interview leads to the selection of participants.
This step aids in predicting the effectiveness of a small group counseling experiences for all
members. There may be pressure to select a particular student for a group, however, the decision
to involve students in any group is at the discretion of the PSC and should be based on the
students readiness. Offer other services to students who are not selected.

Document 6: Small Group Counseling Screening/Selection Procedures

STEP 6. Obtain Informed Consent: Although local policy will determine the level of informed
consent and when it occurs; it is ethical professional practice to obtain informed consent for all
participants in a group. While parental consent is required for minors, it is expected that PSCs
obtain student assent as well.

The informed consent step may occur prior to screening interviews. The consent form should
provide specific information about the small group so that the student/parent/guardian can make
an informed decision about whether or not to participate. Professional school counselors are
ethically required to maintain current knowledge about state/national legislation, local school
board policy, and the American Counseling Association (ACA), the American School Counselor
Association (ASCA) and Association for Specialists in Group Work (ASGW) Ethical Standards for
legal and ethical guidelines.

Document 7: Small Group Counseling Informed Consent Forms
Document 8: Small Group Counseling: Participant Guidelines/Ground Rules

STEP 7. Collect Pre-Group Data: Planning ahead for data collection is critical. Before the group
begins, determine the data to collect. Data may be objective (e.g., grades, attendance, office
referrals) and/or subjective (e.g., observations, parental reports, student interviews). Data
collection allows the PSC to design group sessions based on the needs of group members and
also provides information for results-based evaluation. (For more information on data collection
see: The Missouri Comprehensive Guidance Program Manual)

Document 4: Small Group Counseling Student Behavior Rating Form
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STEP 8. Conduct Sessions:
Document 8: Small Group Counseling: Participant Guidelines/Ground Rules
Document 9: Small Group Counseling Student Hall Passes (3 samples)
Document 10: Small Group Counseling Unit Template
Document 11: Small Group Counseling Group Session Template
Document 12: Small Group Counseling Group Session Teacher/Parent/Guardian Follow-Up
Part 5 Sample Group Units and Sessions

STEP 9. Collect Post-Group Data: Post-group data, in conjunction with pre-group data, measures
individual and group changes. In order to compare data effectively, it is critical to use identical
pre- and post-group data collection criteria and procedures. For example, if you used Document
4: Small Group Counseling Student Behavior Rating Form to collect pre-group data, it should be
utilized to collect post-group data as well.

STEP 10. Conduct Post-Group Follow-Up: The follow-up session (4-6 weeks later) encourages
accountability for goals and allows group members the opportunity to share successes and
develop further strategies for working on issues.

Document 13: Small Group Counseling Group Member Post-Group Follow-Up Interview Form

STEP 11. Conduct Evaluation: The evaluation may include a comparison of pre- and post data, as
well as results of the follow-up session and surveys of parent and teacher perceptions of the
effectiveness of the group. The professional school counselor may also use the small group
counseling action plan to evaluate the effectiveness of the unit. A brief report may be useful
when reporting results to teachers, administrators, parents, students, and other stakeholders.
(See The Missouri Comprehensive Guidance Program Manual for information about evaluation
procedures).

Document 14: Small Group Counseling Teacher Pre/Post-Group Perceptions Form
Document 15: Parent/Guardian Post-Group Perceptions
Document 16: Group Member Post-Group Perceptions Feedback Forms

Adapted from Morganett, R. S. (1990) Skills for living: Group counseling activities for young adolescents.
Champaign, IL: Research Press.
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Documents for Small Group Counseling Module

Document 1. Information for School Personnel

Document 2. Needs Assessment/Student Referral Forms (3 Samples)

Document 3. Assessment of Students Perceived Needs

Document 4. Student Behavior Rating Form

Document 5. Action Plan Template

Document 6. Screening/Selection Procedures

Document 7. Informed Consent Forms

Document 8. Participant Guidelines/Ground Rules.

Document 9. Student Passes (3 samples)

Document 10. Unit Template

Document 11. Session Template

Document 12. Group Session Teacher/Parent/Guardian Follow-Up

Document 13. Group Member Post-Group Follow-Up Interview Form

Document 14. Teacher Pre/Post-Group Perceptions (2 Samples)

Document 15. Parent/Guardian Post-Group Perception

Document 16. Group Member Post-Group Feedback Forms

NOTE: The documents in this module parallel the documents within each of the small group units. Various
components were developed by different teams of professional school counselors over a period of time, and
editing changes made. Therefore, slight differences may be noticed in similar forms, and slight variations may
occur in titles.
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DOCUMENT 1:
SMALL GROUP COUNSELING: INFORMATION FOR SCHOOL PERSONNEL

To: School Personnel
From: ________________, Professional School Counselor
Re: Small Group Counseling
Date: _________________

Complete and return the attached form to the Guidance and Counseling Office no later than
__________.

Our districts Comprehensive Guidance Program (CGP) helps all students develop skills in the
areas of personal/social, academic, and career development. For those students who need
additional support, we offer individual and/or small group work.

Small group counseling opportunities are offered throughout the year. The groups help students
remove the barriers to their school success, they support and enhance students development of
social skills and support and promote students educational achievement. I need your input as I
organize the groups for this year. As you get to know your students and specific needs arise,
small group counseling may meet the unique needs of individual students.

Please review the following information about possible group topics. Complete the attached
Document 2: Small Group Counseling Needs Assessment/Student Referral to identify relevant
group topics and recommend students for participation in specific groups. Fell free to suggest
additional topics that will benefit your students and their school success.

Please note that small group counseling may not be the best way to meet the needs of every
student. The screening process will help determine the appropriateness of small group
counseling for each student.

Possible small group topics:

Family Changes: Intended for students whose barriers to school success include challenges
related to such life events as divorce, death, loss, moving, break-ups, injury, incarceration,
military deployment. Groups will focus on helping students identify thoughts and feelings,
develop coping strategies and identify support systems that exist in their environment.

Healthy Choices: Intended for students whose barriers to school success include challenges
related to personal choices such as eating patterns, exercise, sleep patterns, stress
management, preventing/managing unhealthy behaviors (e.g. self-mutilation, substance abuse).
Groups will focus on identifying triggers, building self-esteem and resilience, and making
healthier, alternative choices.

Note: Document 1 may to be used to: remind school personnel of the scope of the Comprehensive Guidance
Program and provide descriptions of group topics. Please modify the information to fit the needs of your local
district and students. It is suggested that Document 1 and Document 2: Small Group: Counseling: Needs
Assessment/Student Referral be used together.
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Interpersonal Issues: Intended for students whose barriers to school success include
relationship challenges related to issues such as bullying, harassment, friendship, conflict,
respect for individual and group differences, dating and intimacy, dealing with authority, teen
parenting and leadership. Groups will focus on building skills to help students identify thoughts
and feelings, triggers, make healthy choices, exercise tolerance and develop self-awareness
and self-control.

Intrapersonal Issues: Intended for students whose barriers to school success include inner
challenges related to issues such as anger management, stress, test anxiety, grief, depression,
school phobia, esteem, self-acceptance and identity development (gender, culture, sexuality,
values). Groups will focus on developing resilience/coping skills, self-advocacy skills, stress-
reduction techniques and skills to improve self-awareness.

Academic Success: Intended for students whose barriers to school success include
challenges related to academic achievement such as study skills/habits, attendance, decision-
making, problem-solving, goal-setting, and transitions/adjustment to new situations. Groups will
focus on problem-solving techniques; steps involved in goal-setting and decision-making; finding
a connection with school; improving study skills, organizational skills and time management;
decreasing test anxiety; and adapting to change.

Career Exploration: Intended for students whose barriers to school success include
challenges relating to knowledge and understanding of the world of work including: awareness
of resources available, aspirations/goal setting, personal planning, work values, self-
assessment, decision-making, transition, communication styles, work readiness, and work
habits. Groups will help students develop awareness of resources and using those resources
now and in the future. Group activities will help students gain skills to enter the world of work
successfully.

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DOCUMENT 2:
SMALL GROUP COUNSELING: NEEDS ASSESSMENT/STUDENT REFERRAL
(SAMPLE 1 OF 3)

Teachers Name: _____________________________________________________________

Grade Level/Subject: ________________________ Planning Time _________________

As a part of the Responsive Services component of our Comprehensive Guidance Program, we will begin
organizing small groups.

Please list the names of students you believe would benefit from any of the following groups. Feel free to suggest
additional topics that will meet the needs of specific students. After we have identified group topics and potential
participants, screening for group membership will begin and members will be selected. Some students may not
be ready to participate in small groups; other interventions will be offered for them. The groups will meet in
the Guidance and Counseling Office for approximately six weeks. Thank you for your assistance in serving the
needs of our students.

Topic: Family Changes Topic: Healthy Choices Topic: Interpersonal Issues
Students Names: Students Names: Students Names:
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________
Topic: Intrapersonal Issues Topic: Academic Success Topic: Career Exploration
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________
Suggested Topic: ____________ Suggested Topic: ____________ Suggested Topic: __________
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________
____________________________ ____________________________ __________________________

Best Days/Times for students to be out of your classroom:

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Note: Document 2 includes three samples of Needs Assessment/Student Referral documents. Any one of the
three may be used in conjunction with Document 1: Small Group: Information for School Personnel. The
samples provide starting points for you and are intended to be modified to fit the needs of your district. The
needs assessment and referral might be done separately, i. e., conduct a needs assessment to determine
priority topics; when topics are selected, request referrals. This is the first of the three samples.
16
DOCUMENT 2:
(SAMPLE 2 OF 3)

We (school counselors) are in the process of organizing small counseling groups and we need your
input. Please identify the topics and students who might benefit from participation in the groups. Small
group counseling topics and meeting times will be determined after reviewing the completed forms.
Each group will meet for approximately _________ minutes, once a week for __________ weeks

Teachers Name: _____________ Grade Level/Subject: __________ Planning Time ______
Please list any students who could benefit from the groups listed. Please rate each students need; add
comments as appropriate.
Rating Scale: 1 Needs help immediately
2 Needs help soon
3 Needs help on social skills or coping skills sometime this year

Name of Group (Description)
Student Name Rating Comments




Please list days/times that are convenient for students to be out of your classroom:
_____________________ ___________________ ___________________
_____________________ ___________________ ___________________

Please complete and return to Guidance and Counseling Office by ___________________.
Thank you!

________________________________________________, Professional School Counselor
Note: This is the second of three sample Needs Assessments/Student Referrals. Any one of the three may
be used in conjunction with Document 1: Small Group: Information for School Personnel. This sample is
designed for you to be able to add your own descriptions of each group. In addition, space is provided for the
referring individual to provide a rating of the level of need and to add comments.
17
DOCUMENT 2:
(SAMPLE 3 OF 3)

Complete and Return to Guidance and Counseling Office by ______________

Teachers Name: _____________________________________________________________

Grade Level/Subject: _____________________________ Planning Time ______________

Please indicate students who may be experiencing barriers to school success in the following areas:

Family Changes: (e.g., Birth of a New Sibling, Divorce of parents, Loss through Death, Relocation,
Incarceration of family member, Domestic Violence, Deployment of Family Members, Parental Re-
Marriage/Blended Families)
___________________________________________________________________________________
___________________________________________________________________________________

Healthy vs. Unhealthy Choices: (e.g., Alcohol and Other Drug Abuse, Choices in Relationships,
Nutrition)
___________________________________________________________________________________
___________________________________________________________________________________

Interpersonal Issues: (e.g., Friendships, Parent/Child Relationships, Teacher/Student Relationships,
Dating)
___________________________________________________________________________________
___________________________________________________________________________________

Intrapersonal Issues: (e.g., Self-Esteem, Self-Mutilation, Teen Parenthood, Anger Management, Thrill-
Seeking Behavior, Transitions)
___________________________________________________________________________________
___________________________________________________________________________________

Academic Success: (e.g., Grades, Attendance, Planning/Organization Study Skills, Special Needs)
___________________________________________________________________________________
___________________________________________________________________________________

Career Success: (e.g., Goal-setting, Proper Preparation/Awareness of Resources)
___________________________________________________________________________________
___________________________________________________________________________________

Note: This is the third of three sample Needs Assessments/Student Referrals. Any one of the three may be
used in conjunction with Document 1: Small Group: Information for School Personnel. This sample--
Document 2: (Sample 3 of 3) Small Group Counseling: Needs Assessment/Student Referralprovides
referring individuals with examples of problems students might face in each of the group topic areas. Sample 3
offers the convenience of not having to refer back to Document 1: Small Group: Information for School
Personnel.
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DOCUMENT 3:
SMALL GROUP COUNSELING: ASSESSMENT OF STUDENTS PERCEIVED NEEDS

SCHOOL DISTRICT NAME
SCHOOL NAME
GUIDANCE AND COUNSELING
Dear Students:

We need your ideas! We are preparing for the group counseling topics to be addressed this year. Counseling
groups are an opportunity for 6-8 students to come together to learn new skills and/or address concerns about such
areas as relationships, making healthy decisions, dealing with divorce in families, study skills and career choices.
What groups would you be interested in joining? What groups do you think your friends/peers might need or be
interested in joining?

RETURN FORM TO GUIDANCE AND COUNSELING OFFICE BY ________________
Provide Name Only If You Want To Participate In A Group

First/Last Name __________________________________________ Grade Level _________

Group Topics
Please check group topics of interest or need and indicate the
groups in which you want to participate.
This would be a
helpful group
for students
I am interested in
participating in
this group
1. Family Changes (e.g. divorce, re-marriage, birth of a sibling)
2. Self-Control
3. Friendship
4. Anger Management
5. Grief/Loss
6. Courage to Make Healthy and Safe Personal Choices
7. Conflict Resolution
8. Relationships with Adults (parents/teachers/others)
9. Belief in Myself
10. Confronting the Bully
11. Study Skills
12. Motivation to Study and Do My Homework
13. Organizing Myself for Studying and Improving My Grades
14. School Success
15. Decision-makingNow and for the Future
16. Questions about lifeand Growing-Up
Other Topics of Interest (use back if necessary)

Your thoughts and comments about groups:
Thanks For Your Input!
Note: This document is an example of an assessment of students perceived needs and/or interest for
themselves and their peers. It may be used in conjunction with a modified version of Document 1: Small
Group: Information for School Personnel. The preferences indicated by students will be helpful as you
determine small counseling group topics to be offered during the current school year.
19
DOCUMENT 4:
SMALL GROUP COUNSELING: STUDENT BEHAVIOR RATING FORM
(Adapted from Columbia Public Schools Rating Form)

STUDENT______________________GRADE ________TEACHER __________________________DATE______

Teachers: please indicate areas of concern in the left
hand column.
Counselor: use columns on right side.
Performance Indicators:
(+) = Excellent (/) = Satisfactory (-) = Area of Concern
Teacher
Concerns

(mark
with X)

Student Work Habits/Personal Goals Observed

Counselor
(Modify to fit school marking
periods (e.g. quarters,
trimesters)
M
a
r
k
i
n
g

P
e
r
i
o
d

1

M
a
r
k
i
n
g

P
e
r
i
o
d

2

M
a
r
k
i
n
g

P
e
r
i
o
d

3

M
a
r
k
i
n
g

P
e
r
i
o
d

4

M
a
r
k
i
n
g

P
e
r
i
o
d

5

Academic Development
Follows directions
Listens attentively
Stays on task
Compliance with teacher requests
Follows rules
Manages personal & school property (e.g., organized)
Works neatly and carefully
Participates in discussion and activities
Completes and returns homework
Personal and Social Development
Cooperates with others
Shows respect for others
Allows others to work undisturbed
Accepts responsibility for own misbehavior (e.g., provoking fights, bullying,
fighting, defiant, anger, stealing)

Emotional Issues (e.g., perfectionism, anxiety, anger, depression, suicide,
aggression, withdrawn, low self-esteem)

Career Development
Awareness of the World of Work
Self-Appraisal
Decision Making
Goal Setting
Add Other Concerns:
External Issues (e.g., divorce, death, abuse, socio-economic, incarceration,
deployment)

Other
School Record Data (To be completed by PSC)
Attendance: # of days absent
Attendance: # of days tardy
Discipline: # of referrals
Grades
Note: (See also Document 14: [Sample 2 of 2]Teacher Post-Group Perceptions). This document is not limited to a single
purposeit may be used in several ways. In the Small Group Counseling Module, it is suggested as a pre-and post-group
measure of students behavior. Used in this way, it forms the basis for evaluating the effectiveness of the group experience. In
addition, the form may be used for referral when a referring individual has multiple concerns about an individual student. The
listing of behaviors is valuable in consultation with other professionals, parents AND students. Modify to fit your needs!
20
DOCUMENT 5:
SMALL GROUP COUNSELING: ACTION PLAN TEMPLATE

ACTION PLAN FOR ______________________ GROUP

Group Description and Rationale
Group Topic: Purpose:
Demonstrated Need for Group:

Group Objectives/Key Points (Clear and measurable)
Unit Objectives:
1.
2.
3.
Session Objectives/Key Points
Session 1 Objectives & Key Points

Logistics
Beginning Date: Ending Date: Minimum/Maximum number of participants:

Time(s) and Day(s) of the Week: Length of each session Number of Sessions:

Location: Room Arrangement:

Legal/Ethical/Moral Considerations, Risks and Safety Issues (Refer to ACA, ASCA, and ASGW
Ethical Standards/Best Practices for guidelines)

Psychological Risks (change is always a risk): What specific risks are inherent in this group?

Informed Consent (Necessary? [Yes] How obtained? From Whom?):

Confidentiality (Even though we cannot guarantee confidentiality when group members leave group sessions, we
can encourage it.: To the extent possible, how will confidentiality be addressed and maintained? What will happen
if the trust of confidentiality is broken?)

Small Group Counseling: Guidelines/Ground Rules (Document 8):

Procedures
Techniques to be utilized (e.g. role playing, board games, discussion, team-building activities, journaling)

Results-Based Evaluation of Groups Effectiveness
Results Based Data Collection Procedures: pre/post results & perceptual data; data analysisHow? By whom?
Report Results: Format? (e.g. Narrative, PowerPoint) To Whom? (e.g. faculty, Board of Education,
Administration)
Note: Develop an Action Plan for each group to be offered. In addition to helping you feel confident as you
begin the groups, written plans prepare you to answer with confidence and competence the hard questions
others may ask about the group process. The Action Plan will prepare you to answer questions from parents,
teachers, and administrators. As with all other forms, modify this to fit your specific situation. (Note: As you
type within the template, the boxes will expand.)
21

22
DOCUMENT 6:
SMALL GROUP COUNSELING: SCREENING/SELECTION PROCEDURES

The importance of the member screening/selection process cannot be overstated. Leaders in the field of
group work emphasize that group member screening/selection can account for the majority of a groups
value to participants. It is beyond the scope of this document to present all aspects of the
screening/selection process. Consult group work literature for a more complete review. This document
presents information that is most relevant to screening/selection of members for voluntary school-based
small group work. As you plan for the selection of group members consider the following:

Your ethical responsibility throughout the screening/selection process.
Not every student will benefit from small group counseling. There may be pressure to select a
particular student for a group, however, the decision to involve students in any group is at the
discretion of the PSC and should be based on the students readiness. Offer other services to
students who are not selected.
Groups present the opportunity for personal growth.
Groups may have the potential for negative effects.
Individuals who are selected as group members must be able to benefit from group experiences
as well as help others benefit.
Individuals who have the potential for hurting themselves or others must have their needs
addressed in another way.

Preparation
Before you screen or interview new members, it is important to be clear about the following:

Group topic
Group goals
Group tasks
Procedures for accomplishing tasks
Target group (for whom is the group intended?)
Group composition (participants grade level, gender, learning style)
Structured versus unstructured group facilitation (see Part 3: Small Group Counseling Module:
Organizing the Small Group Counseling Experience)
Membership: open versus closed (see Part 3: Small Group Counseling Module: Organizing the
Small Group Counseling Experience)
Group Action Plan, it will help develop clarity about the group

**For more information on group processes, refer to Part 4: Small Group Counseling Module:
Resources.

Note: The information in this document will guide you through the selection of group members.
Screening/selecting group members is a critical step. It is the PSCs responsibility to educate others about the
need to choose group members carefully. PSCs must strive to ensure that all students will have a successful
group experience. PSCs should also offer alternatives to students who are not selected as group members.

Before you begin: Read/Review: ACA / ASCA / ASGW Ethical Standards/Best Practices, especially ACA
Standard A.8 Group Work; ASCA Standard A-6 Group Work; and ASGW Best Practices Standard A.7 Group
and Member Preparation. The links will take you to the complete ethical standards/best practices documents for
each organization. If you are not familiar with the Association for Specialists in Group Work (ASGW), you are
encouraged to familiarize yourself with the Training Standards as well as the Best Practice Standards.
23
Pre-Group Screening Interviews
Keep two assumptions in mind throughout the screening process:
The group is an agent of change
Group members interactions produce therapeutic results, for self and for other members.

When the group begins, the PSC and each group member must:
Understand and accept the ground rules
Agree to maintain confidentiality
Understand group member responsibility with regard to confidentiality
Understand leader responsibility with regard to confidentiality

Goals of Screening Interviews:
To select individuals who will contribute to a climate that maximizes open interaction
between and among group members.
To select individuals who will actively work toward individual and group goals.
Not all students will meet selection criteria. Students who are not selected may feel rejected. It is your
ethical responsibility to talk with them about their non-selection and provide an alternative.

Rosemarie Smead (Morganett), a leader in school-based group work, has developed the TAP-In
process (Morganett, 1990) for pre-group screening interviews:

Tell student about the group.
Ask student about his or her level of interest/commitment to expectations of group,
Pick participants.

The following lists are examples of the questions you might ask during the screening interview. All
factors will be weighed when it comes time for the final selection. A positive or negative response to a
question does not automatically indicate acceptance/non-acceptance of an individual. Your goal is to
pick students who will benefit themselves as well as others in the therapeutic process of meeting the
goals of the group.

ell about the Group:

Describe the group:
Group topic
Meetings: day, time, length of each session, total number of sessions
Expectations of participants: attend every meeting unless there is an illness or an emergency
Reason student is being considered for membership in group
Explain that only a few students will be able to participate and what not being chosen means.
Participation in the group is voluntary.
Tell student what he or she will gain from being in the group
Goals/outcomes
Meet new people and get to know others better
Work on individual as well as group goals.
Learn new skills
Being in a group can be fun.
Tell the student about the expectations of members of a small group.
Attend the group every week.
Not an option to forget group
Attend every session unless there is an extreme situation
T
24
He or she is expected to maintain confidentiality about what occurs in the group.
Everything said in the group stays in the group.
PSC keeps information confidential unless:
Someone (outside the group) is hurting a participant
A group member is hurting someone
A group member is thinking about hurting himself or herself
He or she is expected to participate.
PSC will make sure everyone gets a chance to talk
Listening is a part of participation
Members help others in the group
Members respect and value each others situation.
Tell student again that he or she may not be selected for this group and what will happen instead

sk the student about his or her interest and commitment

Ask student to explain his or her understanding of what you have said about the group.
Ask student what questions he or she has about any part of the group process.
Ask student if he or she wants to be in the group, and why or why not
Ask if student is seeing another counselor, inside or outside school.
Ask if student is willing to adhere to expectations/ground rules (e.g. attendance, confidentiality,
cooperative participation, sharing information about thoughts and feelings related to topic).
Ask student what his or her goals for growth are (or might be).
Ask student to rate his or her interest in participating in the group on a scale of 1-10.

ick members

Is the student willing to participate in the primary tasks of the group?
What is the students reason for wanting to be in the group?
Hypothesize whether student will be satisfied with:
The group focus and being able to meet personal needs or goals
Other members in the group
The process of working in a group and an overall enjoyment of group work
Will student be able to apply/transfer group experiences to other life areas/relationships
Has student experienced a recent crisis or situation that would block participation in this group?
During interview, was student able to interact with you on a personal level?
Are students expectations aligned with stated group outcomes/other members expectations?
On a scale of 1-10, how motivated is student to participate fully in the group experience?

Final Selection
Unfortunately, there is not a magic formula that will predict any one students effectiveness as a group
participant. The T-A-P questions provide direction and information that must be balanced with what you
know about the group, the student, yourself, your professional wisdom and intuitive reaction. The most
difficult part may well be informing the students who are not selected in a way that helps them maintain
their valuing of themselves and to view alternative strategies as being just as much fun as you
promised the group would be.

Reference:
Morganett, R. S. (1990). Skills for living: Group counseling activities for young adolescents. Chicago: Research
Press.
A
P
25
DOCUMENT 7:
SMALL GROUP COUNSELING: INFORMED CONSENT (SAMPLE 1 OF 2)

Dear Parent/Guardian:

Our districts Comprehensive Guidance Program emphasizes the importance of academic and life success for
every student. During the school year, students have the opportunity to participate in small groups. Small group
counseling is an excellent way for students to learn skills, develop self-awareness and confidence, practice new
behaviors, and better understand how to effectively deal with some of the issues/concerns life presents. We have
found that when we work with students in groups, they gain support from others who are experiencing similar
situations or who have adjusted well after experiencing a similar situation in the past.

Your child has expressed an interest in participating in a group called __________ which will begin on __________.
The group will focus on helping students identify and understand common thoughts and feelings associated with
the experience of ________________, developing positive coping strategies and learning from the shared
experiences of other students in similar circumstances. This group will meet _____________ for approximately
_________ weeks for _______________ each week. We will meet at different times during the school day to
minimize the content missed in each class. Classroom requirements will take precedence over group participation.

Please understand that participation in the group is completely voluntary and student confidentiality is addressed
and respected. The exception to this is my legal and ethical responsibility to take appropriate action in the case of
an individual intending to do harm to self or others; if abuse or neglect is suspected, if illegal activity is reported to
me or if I am required to do so by a court of law. Please contact me at (____) _________ if you have questions or
desire further information about the group.

In order for your child participate in this group, district policy requires your signed consent. Please sign, date the
following form and return it to the Guidance and Counseling office by ______________________.

Educationally,

__________________________, Professional School Counselor

Phone Number (___) ________Email Address ____________________Web Site: ______________________

- - - - - - - - - - - - - -cut here, return bottom portion and keep the top portion for your records- - - - - - - - - - -

Consent/Non-Consent to Participate In Group
Please return to the Guidance and Counseling office by ________________________

I have read the information provided by the Professional School Counselor and have had an opportunity to ask
questions about small group counseling for my child.

___ I give consent for my child to participate in the___________________ group. I understand that participation
is completely voluntary and that classroom requirements take precedence over group participation.

___ I do not give consent for my child to participate in the _______________________________ group.

__________________________________________ ____________________________
Student Name Date

____________________________________ ________________________________ ____________
Parent/Guardian Name Parent/Guardian Signature Date
Note: Document 7: Small Group Counseling: Informed Consent includes two sample documents for
obtaining the consent of parents/guardians. The two samples are similar and offer you the opportunity to modify
one or the other or to combine the two. According to Stone (2005) when considering informed consent it is
important to remember that parents and guardians have the (legal) right to be the guiding voice in students
lives. If a parent does not give consent, accept the decision. It is their right. This is the first of the two
samples.
26
DOCUMENT 7:
SMALL GROUP COUNSELING: INFORMED CONSENT (SAMPLE 2 OF 2)

School Name
Comprehensive Guidance Program

Dear Parents/Guardian/Student,

Our districts Comprehensive Guidance Program includes the opportunity for students to participate in
small group counseling experiences. We will be beginning this years groups on _______. Each group
will meet once a week for approximately ________ minutes each week. We will rotate the times that we
meet to follow-through on the districts goal of maximizing your sons or daughters academic progress.
Even though the small group counseling experience will have a positive effect on your childs progress,
the immediacy of classroom requirements will take precedence over group participation.

(PSCAdd description of group heree.g.: The anger management group is designed for high school
students who are having trouble managing their anger. We will be discussing not only what triggers
angry outbursts, but also positive ways to control this anger.)

Please note that participation in the group is completely voluntary and confidentiality will be addressed
and respected. Please sign the form below to indicate your consent (or non-consent). Please include
comments that might be beneficial when working with your son or daughter. Complete and return the
consent portion to the Guidance and Counseling office no later than __________. You may contact me
for more information at the number below.

______________________________________, Professional School Counselor
Phone Number: (_____) ______-__________
Email Address _______________________________ Web Site _______________________________

- - - - - - - - - - - - - - - - - - - -- - - - - - - - cut here and return lower portion - - - - - - - - - - - - - - - - - - - - - - - - - -

Consent for Participation in: __________________Group
Please Return to the Guidance and Counseling Office by: ____________________

__________________________________ _____________________________________
Student Name Student Signature* Date
*Students age eighteen and over may or may not be required to have a parent/guardian signature.

I give my consent for my son or daughter to participate in the _____________ Group.
I do not give my consent for my son or daughter to participate in the ____________ Group.

Parent/Guardian (please print) ___________________________ Phone ______________ e-mail ________

__________________________________________________ __________________
Parent/Guardian Signature Date
Note: This is the second of two samples of informed consent. Note that this sample includes a place for the
students signature. In the case of a student who is 18 or older, parental permission may or may not be
required. It is incumbent upon high school PSCs to familiarize themselves with local/state law when considering
informed consent for participation of married students, emancipated students, 18 or older students who are
considered dependents by tax code.
27
DOCUMENT 8:
SMALL GROUP COUNSELING: GUIDELINES/GROUND RULES

Guidelines/Ground Rules for Our Group

The following Ground Rules are suggestions to help generate additional group ground rules. Group members will
delete and/or add items. It is anticipated that the ground rules will be slightly different for each topic group. The
What it Looks Like and What it Sounds Like columns are included in order to allow group members to
express in their own words what each rule means.

What it
Looks Like
What it
Sounds Like
1. All group members understand and respect
confidentiality.

a. Professional School Counselor
b. Group members
2. One person speaks at a time.
3. Everyone has an opportunity to participate
and share.

4. No Put-Downs are allowed (e.g. snickering,
name calling, negative comments, etc.)

5. All group members will treat each other with
respect.

6. Make every effort to be on time
7. All group members are encouraged to
actively participate

8. Group members have the right to pass on an
issue

9. Group members will be encouraged to have
an open mind and accept where other group
members are in their development.

10. Group members will have the opportunity to
develop other guidelines.

11.

12.

Note: Commonly understood Ground Rules provide group members and the PSC with parameters for
monitoring participation. Ground Rules are most effective when they are posted and reviewed at the beginning
of each session. Referencing Ground Rules helps maintain their importance. Encouraging group members to
monitor participation creates a sense of ownership and facilitates group members mutual responsibility for the
effectiveness of the group.
28
DOCUMENT 9:
SMALL GROUP COUNSELING: STUDENT PASS (SAMPLE 1 OF 3)

Name of District/School
Student Hall Pass

The following student has permission to be out-of-class for an appointment on _____________
Date
at ____________ in the Guidance and Counseling Office.
Time

Students Name: __________________________________ Class _______________________

Classroom Teachers Name & Signature ____________________ ___________________

Time Student Left Guidance and Counseling Office ________________

Professional School Counselors Signature __________________________________________

Missouri Comprehensive Guidance Programs: Linking School Success with Life Success

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Student Hall Pass

The following student has permission to be out-of-class for an appointment on _____________
Date
at ____________ in the Guidance and Counseling Office.
Time

Students Name: __________________________________ Class _______________________

Classroom Teachers Name & Signature ____________________ ___________________

Time Student Left Guidance and Counseling Office ________________

Professional School Counselors Signature __________________________________________

Note: This document includes three sample passes. The passes serve three primary purposes: 1. to validate
students being out-of-class, 2. to serve as a reminder of group meeting times, 3. to verify that students attended
the group session. They may be put in teachers mailboxes on the day of the group session. If your district has
a standard form to be used as a hall pass, consider other means for reminding teachers and students of group
sessions. (Consider printing the form on brightly colored paper. Use the same color for all passes/reminders of
appointments in the Guidance and Counseling Office.)
29
DOCUMENT 9:

Date ______________

To: __________________________ Class/Teacher ___________ ___________________

Please come to your counseling group at ____________ on _________________
(Time) (Date)
Comments:
____________________________________________________________________________
____________________________________________________________________________
Thank you, _________________________________________, Professional School Counselor

PSCs initials _________________ Time student left group session___________________


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Date ______________

To: __________________________ Class/Teacher ___________ ___________________

Please come to your counseling group at ____________ on _________________
(Time) (Date)
Comments:
____________________________________________________________________________
____________________________________________________________________________
Thank you, _________________________________________, Professional School Counselor

PSCs initials _________________ Time student left group session___________________

Note: This document differs from the first sample because it specifies participation in small group counseling
and provides a space for your comments and/or reminders of group materials to take to session.
30
DOCUMENT 9:

Date ______________

To: __________________________ Class/Teacher ___________ ___________________

Please come to:
The Guidance & Counseling Office today at __________ with your teachers permission.
The Guidance & Counseling today the last _____ minutes of ______ hour with your
teachers permission.
Your counseling appointment at ______________ on ___________________________.
(Time) (Date)
Comments:
____________________________________________________________________________
____________________________________________________________________________
Thank you, ___________________, Professional School Counselor

PSCs initials _________________ Time student left session ______________________________


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Date ______________
To: __________________________ Class/Teacher ___________ ___________________
Please come to:
The Guidance & Counseling Office today at __________ with your teachers permission.
The Guidance & Counseling today the last _____ minutes of ______ hour with your
teachers permission.
Your counseling appointment at ______________ on ___________________________.
(Time) (Date)
Comments:
____________________________________________________________________________
____________________________________________________________________________
Thank you, ___________________, Professional School Counselor

PSCs initials _________________ Time student left session ______________________________

Note: This sample may be used as a generic pass to the Guidance and Counseling Office.
31
DOCUMENT 10:
SMALL GROUP COUNSELING: UNIT TEMPLATE

GROUP TITLE/THEME:

Grade Level(s):
Small Group Counseling Description:
Number of Group Sessions:

Session Titles/Materials:
Session # 1:
Materials needed:
Session # 2:
Materials needed:
Session# 3
Materials needed:
Session # 4
Materials needed:
Session # 5
Materials needed:
Session # 6
Materials needed:

Missouri Comprehensive Guidance Program Big Idea

Missouri Comprehensive Guidance Program Concept(s):

American School Counselor Association National Standard (ASCA):

Show-Me Standards: Performance Goals (check one or more that apply)
Goal 1: gather, analyze and apply information and ideas
Goal 2: communicate effectively within and beyond the classroom
Goal 3: recognize and solve problems
Goal 4: make decisions and act as responsible members of society

Outcome Assessment (acceptable evidence):
Summative assessment relates to the performance outcome for goals, objectives and concepts (GLEs).
Assessment may be survey, whip around, action plan, role play and/or other means for students to
demonstrate their ability to apply the concepts in new situations.

Follow Up Ideas & Activities
Implemented by counselor, administrators, teachers, parents, community partnerships

Note: This document (Unit Template) and the next (Session Template) will guide in the planning of counseling
groups. It is a companion to Document 5: Small Group Counseling: Action Plan For _ Group. A written
plan guides the development of the details of issues related to the overall logistics and ethical/legal
considerations, while the Unit and Session templates guide the development of the details of the group-in-
action. There may be some overlap; however, each serves a unique purpose and all three are important to the
successful implementation of group counseling experiences for students. (Note: As you type within the
template, the box will expand.)
32
DOCUMENT 11:
SMALL GROUP COUNSELING: GROUP SESSION TEMPLATE

GROUP TITLE:

Session Title: Session # ______of _____
Grade Level: Estimated Time:

Small Group Counseling Session Purpose:

Missouri Comprehensive Guidance Big Idea:

Missouri Comprehensive Guidance Program Concept(s)

American School Counselor Association National Standard (ASCA):

Materials (include activity sheets and/or supporting resources)

Session (Formative) Assessment

Session Preparation
Essential Questions:

Engagement (Hook):

Procedures
Professional School Counselor Procedures:
1.
2.
3.
4.
5.
Student Involvement:
1.
2.
3.
4.
5.

Follow-Up Activities (Optional)
PSC will provide suggestions for follow-up activities to be implemented by counselor, administrators, teachers,
parents, community partnerships

Counselor reflection notes (completed after the lesson)
STUDENT LEARNING: How will students lives be better as a result of what happened during this lesson?

SELF EVALUATION: How did I do?

IMPLEMENTATION PROCEDURES: How did the session work?

Note: This template provides guidelines for developing counseling group sessions outlined in the Unit Plan and
your Action Plan. (Note: As you type within the template, the box will expand.)
33
DOCUMENT 12:
CLASSROOM TEACHER/PARENT/GUARDIAN
SMALL GROUP SESSION FOLLOW-UP FORM

GROUP TOPIC: _____________________________________ Session # _________

GROUP TOPIC: ___________________________________________ Session # _________

Students Name: ___________________________________ Date: ____________________

Today I met with my school counselor and other group members.

Session Goal: _______________________________________________________________

Today we talked about the following information during our group:
Circle one or more items.

Friendship Study Skills Attendance

Feelings Behavior School Performance

Family Peer Relationships Other ________________

Group Assignment:
I will complete or practice the following at school and/or at home before our next session:

_____________________________________________________________________

Our next group meeting will be:

Date: ____________________________ Time: ____________________________

Additional Comments:

Please contact ___________________________, Professional School Counselor at

_____________ if you have further questions or concerns.
Note: The Professional School Counselor has the option of sending this form to teachers/ parents/guardians
after each group session to keep these individuals informed of students progress in the group.
34
DOCUMENT 13:
SMALL GROUP COUNSELING: STUDENT POST-GROUP FOLLOW-UP INTERVIEW FORM

Follow-up Interviews/Session with Students

Potential Interview Questions:
How are things going?

What specific skills are you practicing now that the group is over?

What was the most useful thing you learned from the group?

What could you use more practice on?

How are things different for you now?

What is better?
What is worse?

What Progress have you made toward the goals you set for yourself at the end of our group
meetings?

How are you keeping yourself accountable?

What suggestions do you have for future groups?

Rank your overall experience on a scale from (low) 1 5 (high): ______

5 = Most positive activity in which I have participated for a long time
4 = Gave me a lot of direction with my needs
3 = I learned a lot about myself and am ready to make definite changes
2 = I did not get as much as I had hoped out of the group
1 = The group was a waste of my time

What specific things contributed to the ranking you gave your experience in the group? What
would have made it better?
Note: This document serves as an example of a way to follow students persistence in making changes. It may also be
used as a means for gathering data about students perceptions of the effectiveness of the group. Students who participate
in follow-up sessions after a group ends are more likely to maintain the gains made. The Professional School Counselor
(PSC) should make arrangements to talk with group members individually and hold at least one more group session 4-6
weeks after the group has ended. The follow-up session will enable the PSC to assess how students are doing on their
goals and the successes they are experiencing as a result of the group. Follow-up sessions provide data that will
demonstrate the proven effectiveness of small group counseling.
35
DOCUMENT 14:
SMALL GROUP COUNSELING: TEACHER PRE/POST-GROUP PERCEPTIONS
(SAMPLE 1 OF 2)

Note: The classroom teacher completes Part 1 of this document before students begin group sessions and
completes Part 2 after the group has been completed. This process will provide the school counselor with follow up
feedback about individual students who participated in the group.
Sample 1: Individual Student Behavior Rating Form
(Adapted from Columbia Public Schools Student Behavior Rating Form)

STUDENT___________________________GRADE __________TEACHER ____________________

DATE: Pre-Group Assessment ___________ Date: Post-Group Assessment _______________

Part 1 - Please indicate rating of pre-group areas of
concern in the left hand column.
Part 2 - Please indicate rating of post-group areas of
concern in the right hand column.
Pre-Group Concerns
Rank on a scale of 51
(5 = HIGH1 = LOW)
Student Work Habits/Personal Goals Observed
Colleagues, will you please help us evaluate the
counseling group in which this student participated.
Your opinion is extremely important as we strive to
continuously improve our effectiveness with ALL
students!
Post-Group Concerns
Rank on a scale of 51
(5 = HIGH1 = LOW)
5 4 3 2 1

5

4

3

2

1
Academic Development
Follows directions
Listens attentively
Stays on task
Compliance with teacher requests
Follows rules
Manages personal & school property (e.g., organized)
Works neatly and carefully
Participates in discussion and activities
Completes and returns homework
Personal and Social Development
Cooperates with others
Shows respect for others
Allows others to work undisturbed
Accepts responsibility for own mis-behavior (e.g., provoking
fights, bullying, fighting, defiant, anger, stealing)

Emotional Issues (e.g., perfectionism, anxiety, anger,
depression, suicide, aggression, withdrawn, low self-
esteem)

Career Development
Awareness of the World of Work
Self-Appraisal
Decision Making
Goal Setting
Add Other Concerns:

Note: Samples 1 & 2 of Document 14 provide you with examples of two ways to gather data about teachers post-group
perceptions of the effectiveness of the group. Sample 1 measures teachers perceptions of the changes the student made as a
result of the group experience. Sample 2 measures the teachers perceptions of the counseling group as a whole. An
advantage to using form 2 is that it parallels Document 15: (Small Group Counseling: Parent/Guardian Post-Group
Perceptions) and Document 16: Small Group Counseling Student Post-Group Perceptions; thus, making it possible to
compare teacher, parent and student perceptions of the group experience.
36
DOCUMENT 14:
SMALL GROUP COUNSELING: TEACHER PRE/POST-GROUP PERCEPTIONS
(SAMPLE 2 OF 2)

TEACHER PRE/POST-GROUP PERCEPTIONS FORM

One or more of your students participated in a small counseling group about _____________. We are
seeking your opinion about the effectiveness of the group e.g., students relationship with the
professional school counselor and other participants in the group and your observations of students
behavioral/skill changes (positive or negative). We appreciate your willingness to help us meet the
needs of all students effectively. The survey is anonymous unless you want us to contact you.

Teachers Name (optional): ___________________________________________ Date: _____________

Professional School Counselors Name: ___________________________________________________

Small Group Title: ____________________________________________________________________

Before the group started, I hoped students would learn:

___________________________________________________________________________________

___________________________________________________________________________________

While students were participating in the group I noticed these changes in their behavior/attitude

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Using a scale of 5 to 1 (5 being the highest and 1 the lowest), please circle your opinion about the
following

What do you think? 5=High 1=Low
Overall, I would rate my students experience in the counseling
group as:
5 4 3 2 1
Students enjoyed working with other students in the group. 5 4 3 2 1
Students enjoyed working with the counselor in the group. 5 4 3 2 1
Students learned new skills and are using the skills in school 5 4 3 2 1
I would recommend the group experience for other students. 5 4 3 2 1
Additional Comments for Counselor:

Note: This document measures the teachers perceptions of the effectiveness of the group as a whole. The
teacher could complete this form after the last group session has been completed.
37
DOCUMENT 15:
SMALL GROUP COUNSELING: PARENT/GUARDIAN POST-GROUP PERCEPTIONS

(Print on SCHOOL LETTERHEAD)

Request for Feedback from Parents/Guardians
Small Group Counseling topic/title: ______________________________________________________

Students Name ________________________________ Teachers Name ________________________
Date: ____________________________________

Dear ____________________________________,

I have enjoyed getting to know your child in our small group counseling sessions. Next week will be the
last session for our group. During the group sessions we shared information related to a variety of
topics. Below is a list of topics discussed during the group sessions.

Session 1: _______________________________________________________________________
Session 2: _______________________________________________________________________
Session 3: _______________________________________________________________________
Session 4:________________________________________________________________________
Session 5: _______________________________________________________________________

Comments from the school counselor about your childs progress:

Attached is a feedback form. I would appreciate input from you about your childs experience in the
small group. Please complete the attached Parent/Guardian Feedback Form and send the completed
form back to school with your child by ___________________________________________.

Thank you for your support and feedback. Please contact me if you have questions or concerns.

Sincerely,

Professional School Counselor
Note: This cover letter and parent feedback form may be sent home with students after the last group session.
38
DOCUMENT 15(contd):
SMALL GROUP COUNSELING: PARENT/GUARDIAN POST-GROUP PERCEPTIONS
.
Parent/Guardian Feedback Form

Your child participated in a small counseling group about _____________. Was this group experience
helpful for your child? Following is a survey about your observations of changes (positive or negative)
your child made at home while participating in the group at school and since the group ended. The
survey will help us meet the needs of all students more effectively. The survey is anonymous unless you
want the school counselor to contact you. We appreciate your willingness to help us

Professional School Counselor: _____________________________________ Date: _______________


Before the group started, I hoped my child would learn _______________________________________

___________________________________________________________________________________

Ive noticed these changes in my childs behavior and/or attitude as a result of participating in the group:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

following:
High Low
What do you think? 5=High 4 3 2 1=Low
Overall, I would rate my childs experience in the
counseling group as:
5 4 3 2 1
My child enjoyed working with the other students in the
group
5 4 3 2 1
My child enjoyed working with the counselor in the
group.
5 4 3 2 1
My child learned new skills and is using the skills in and
out of school
5 4 3 2 1
I would recommend the group experience to other
parents whose children might benefit from the small
group.
5 4 3 2 1
Additional Comments:

Note: This cover letter and parent feedback form may be sent home with students after the last group session.
39
DOCUMENT 16:
SMALL GROUP COUNSELING: GROUP MEMBER POST-GROUP PERCEPTIONS
(Sample 1 of 2)

GROUP MEMBER FEEDBACK FORM: OVERALL EFFECTIVENESS OF GROUP

We want your opinion about the effectiveness of your group. We appreciate your willingness to help us
make our work helpful to all students. The survey is anonymous unless you want us to contact you.

My Name (optional): ___________________________________________ Date: __________________

Professional School Counselors Name:___________________________________________________


Before the group started, I wanted to learn _________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Because of the group, I have noticed these changes in my thoughts, feelings, actions:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

following

What do you think? 5=High 1=Low
Overall, I would rate my experience in the counseling group as: 5 4 3 2 1
I enjoyed working with other students in the group 5 4 3 2 1
I enjoyed working with the counselor in the group. 5 4 3 2 1
I learned new skills and am using the skills in school 5 4 3 2 1
If other students ask me if they should participate in a similar
group, I would recommend that they give-it-a-try
5 4 3 2 1
Additional Comments for the Counselor:

Note: This cover letter and parent feedback form may be sent home with group members after the last group
session. This form measures the group members perceptions of the overall effectiveness of the group using
the same questions as teachers and parents answer on their feedback forms. Group members complete during
the last session (or the follow-up session if you have one). This is the secondary level form.
40
DOCUMENT 16:
SMALL GROUP COUNSELING: GROUP MEMBER POST-GROUP PERCEPTIONS
(Sample 2 of 2)

Group Member Feedback Form

Directions: Please complete the Student Feedback Form after the unit has been completed.

Name: ___________________________________ (optional) Date: ____________________

When I started the group, I wanted to learn _____________________________________about
(the topic of the group).

Instructions: Read each sentence. Put a circle around the face that shows how you think and
feel right now about what you learned in the group.
= I agree = Im not sure = I disagree
_________________________________________________________________________________________
1. Overall, I would rate my experience in the counseling group as:

2. I enjoyed working with other students in the group
3. I enjoyed working with the counselor in the group.

4. I learned new skills and am using the skills in school.

5. If other students ask me if they should participate in a similar group, I would recommend that they
give-it-a-try

Additional comments you would like to share with the counselor:

Note: This cover letter and parent feedback form may be sent home with group members after the last
group session. This form measures the group members perceptions of the overall effectiveness of the
group using the same questions as teachers and parents answer on their feedback forms. Group members
complete during the last session (or the follow-up session if you have one). This is the elementary level
form.
41


Part 4: SMALL GROUP COUNSELING RESOURCES

I. Web Pages for Agencies/Organizations
A. Missouri Department of Elementary and Secondary Education (DESE):
Guidance and Placement
http://dese.mo.gov/divcareered/guidance_placement_index.htm
Information about career education/guidance in the State of Missouri; site
includes links to other DESE Divisions and national resources.
B. Missouri Center for Career Education (MCCE)
http://missouricareereducation.org/curr/cmd/guidanceplacementG/elearning/
Materials related to the Missouri Comprehensive Guidance Program. Check
back often because new resources are added as they become available.
C. Missouri School Counselor Association (MSCA): State association for
Professional School Counselors (PSC)
http://schoolweb.missouri.edu/MSCA/
Information and materials related to PSCs and the profession. Includes links to
Missouri Comprehensive Guidance Program resources.
D. American Counseling Association (ACA): Association for all Professional
Counselors
http://www.counseling.org
The ACA website provides links to all Divisions, including ASCA and ASGW.
ACA represents professional counselors in all specialty areas. The link to the
counseling professions over-arching ethical standards is especially relevant for
the Small Group Counseling Module.
E. American School Counseling Association (ASCA): Association for information
and materials related specifically to the profession of school counseling.
http://www.schoolcounselor.org
The on-line bookstore is a resource for the latest in publications related to school
counseling. Position papers on specific topics, such as group work are helpful to
PSCs as they develop local policy.
F. Association for Specialists in Group Work (ASGW): Association for information
regarding group work
http://www.asgw.org
Training Standards and Best Practices in group work.
Note: Inclusion on the list of print resources does not imply endorsement by the Missouri Department
of Elementary and Secondary Education (DESE). PSCs may use the resources as they plan,
implement and evaluate school-based small group counseling. The list is limited. Please help us
expand the list. Let us know about electronic or print resources that you have found valuable in your
work. Send your ideas to Bragg Stanley, DESE Director of Guidance and Placement
([email protected])
42

II. Print Resources
Association for Specialists in Group Work (2007). Special issue on group work in the
school: Innovative thinking and practice to support school improvement initiatives.
The Journal for Specialists in Group Work, 32(1), entire issue.
Association for Specialists in Group Work (2007). Special issue on group work in the
school: More Innovative thinking and practice to support school improvement
initiatives. The Journal for Specialists in Group Work, 32(2), entire issue.
Brigman, G. & Earley, B. (2001). Group Counseling for School Counselors: A Practical
Guide. Portland, ME: J. Weston Walch Publishing
Littrell, J. M. & Peterson, J. S. (2005). Portrait and model of a school counselor. Boston:
Lahaska Press (Houghton-Mifflin Company).
Morganett, R. S. (1990). Skills for living: Group counseling activities for young
adolescents. Champaign, Ill: Research Press
Morganett-Smead, R. (1994). Skills for living, elementary: Group counseling activities for
elementary students. Champaign, IL: Research Press
Peterson, J. (2007), Essential guide to talking with teens: 50 guided discussions for
school & counseling groups. Chapin, SC: Free Spirit.
Remley, T. P., Hermann, M. A. & Huey, W. C. (2003). Ethical & legal issues in school
counseling, 2
nd
edition. Alexandria, VA: American School Counselor Association.
Senn, D. (2003). Small group counseling for children grades 2-5. Chapin, SC:
YouthLight, Inc.
Senn, D. (2004). Small group counseling for children grades k-2. Chapin, SC:
YouthLight, Inc.
Smead, R. (1995). Skills and techniques for group work with children and adolescents.
Champaign, IL: Research Press
Smead, R. (2000). Skills for living: Group counseling activities for young adolescents,
Volume 2. Champaign, IL: Research Press
Stone, C. (2005). School counseling principles: Ethics and law. Alexandria, VA:
American School Counselor Association.
Vernon, A. (2006). Thinking, feeling, behaving: An emotional education curriculum for
children (Revised Edition). Champaign, IL: Research Press
Vernon, A. (2006). Thinking, feeling, behaving: An emotional education curriculum for
adolescents (Revised Edition). Champaign, IL: Research Press
43

PART 5: SMALL GROUP COUNSELING SAMPLE UNITS AND SESSIONS

Part 5 of the Small Group Counseling Module includes the following sample units and sessions:

STRAND: PERSONAL AND SOCIAL DEVELOPMENT
Units/Sessions: Personal and Social Development
Anger Management Anger Management Anger Management Anger Management
Family Changes Family Changes Loss/Grief/Divorce Grief
Conflict Resolution Conflict Resolution Healthy Relationships
Self Control Self Control
Grief Grief
Friendship Friendship

STRAND: ACADEMIC DEVELOPMENT
Units/Sessions: Academic Development
Study Skills Study Skills Study
Skills/Organization
Tools for Success
Homework New Student

STRAND: CAREER DEVELOPMENT
Units/Sessions: Career Development

Self-Esteem Self-Esteem Career/Transition Personal Planning
Senior Decision Time

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