AN EXPERIMENT IN GROUP THERAPY WITH SHY ADOLESCENT GIRLS

AN EXPERIMENT I N GROUP THERAPY W I T H SHY ADOLESCENT GIRLS*

PEARL L. AXELROD Lung ley Porter Clinic, San Francisco

MYRNA S . CAMERON MI. Zion Hospital, San Francisco

Camp Kohler, Ca/ifornia' CAPTAIN JOSEPH C. SOLOMON, M.C., A.U.S.

REATMENT of adolescents has always been difficult. Too old readily to T accept adults as substitute parents, they are, for the most part, too young to have sufficient insight to seek help for their problems. Agencies with depleted staffs, due to the war, may be interested in our experiment of.individualized group treatment with shy girls. However, group therapy should not be considered solely a war time technique; it offers a particularly valuable approach in dealing with the adolescent.

The group presented in this report was created as a medium through which individuals could form relationships a t a pace commensurate with their emotional capacity to do so. It was planned that one of the leaders, a psychiatric social worker, should offer individual interviews to members of the group as they evinced a desire or readiness for such contacts. While complications arising from an attempt a t individual therapy within a group were anticipated, we sought to test the extent to which this method might serve our purpose of helping these withdrawn adolescents achieve better social adjustment.

The immediate stimulus for the formation of the group was the referral of two adolescent girls to a psychiatry clinic by a family service-agency. The unsuccess- ful attempts in reaching these girls, even with the most prolonged efforts of skillful workers, were called to our attention by the referring social worker. A review of the case records revealed these girls were shy and retiring, and so uncomfortable in the office interview that case work treatment had not been effective. We wondered whether they might better be handled through the medium of group therapy. Since such a.group was not available, a program was instituted with these two girls as a nucleus.

The eleven girls chosen were uniformly described as being unable to make normal social and community adjustments. They were shy, withdrawn, fearful and friendless. Care was exercised to have as homogeneous a group as possible. All were Jewish and approximately from the same social level. IQ's ranged from 85 to 1 1 5 ; all were in the 8th or 9th grade, and the age range was slightly over two years.

To prepare the girls for participation in the group rested with the case workers in the family agency. The project was presented as an opportunity for following their interests and having fun. The leadership of the group was under the direc-

This experiment was conducted while the writers were employed at the Mount Zion Psychiatq * Presented at the 1944 meeting.

Clinic in San Francisco.

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AXELROD, CAMERON AND SOLOMON 6x7

tion of a trained psychiatric social worker with forqer experience in working with difficult children in groups. She was assisted by a trained recreational therapist, and a pychiatrist was available for consultation.

A detailed study of the agency case records was made, supplemented by conferences with the case workers and a psychiatrist. Individual recreational interviews were then held with the girls. While the interviews were presented to the girls as a means of exploring their recreational and social interests, two other pur- poses were prominent in our interview planning. Meeting the leader prior to the initial meeting of the group, and the knowledge that familiar materials would be available, gave these shy girls a measure of security in facing a new group situation. In each interview some interpretation of the special nature of the project was given. These interpretations derived from the girls’ own expressions of a desire for, but inability to have, the normal social contacts other girls experienced. This process of preparation enabled all the girls to appear for the initial meeting.

Before considering the process with the group, and discussing the results, a brief resume of each girl may be of interest.

JANE, fourteen, was a disturbed girl who came from an unstable home. Both parents had deserted on several occasions and efforts had been made to place the children. She was described as being negativistic, untidy, jittery, and obviously unhappy. She was shy and found it difficult to relate to her contemporaries.

EVELYN, fifteen, was the oldest in a familyof four. Her father had spent the last six years in a mental hospital. She was fairly attractive, but rigid, cold, and devoid of expression. She was so defensive that it was difficult to evoke any feeling or response; quiet, shy and completely without friends. For five years several skillful workers from the family agency had tried to help this girl work through her problems, and found her unresponsive. Attempts to assist her in forming group relationships had also met without success.

MILDRED, fourteen, shy and withdrawn, gave the impression of being afraid. Her voice was low, almost inaudible, on the rare occasions when she attempted to talk. She was poorly dressed, untidy, even dirty, and seemed to have little desire to look attractive. There was a long history of economic difficulty, and a somewhat unstable home situation.

CORINNE, fourteen, was characterized as being inhibited, fearful, almost ob- sessive in her personal habits, with an exaggerated need to comply with her parents wishes. Both parents were more than ordinarily severe and laid stresson decorum and respect for adults. She was encouraged to pursue “ladylike” activities, and the mother had commented to the social worker with considerable pride that “Corinne is too good a girl to be interested in boys.” Her major interests were of a solitary nature, such as reading books and listening to the radio; there were no sustained friendships.

ANN, thirteen and a half, was an extremely unhappy, neurotic girl. Her jittery, aggressive behavior and constant demands for attention made her unpopular. Both parents and the brother had been recent patients a t the Psychiatry Clinic,

618 GROUP THERAPY WITH SHY ADOLESCENT GIRLS

but attempts to refer Ann had failed to bring any response. Two months prior to the formation of the group she had been placed in a foster home.

JUDITH, an attractive, friendly adolescent, was anxious, restless, and insecure. Her home was chaotic, with the mother a borderline psychotic and the father frequently incarcerated. This situation, and the obvious rivalry with three more attractive sisters, increased her uncertainty in meeting adolescent problems. She made a superficial adjustment to people but had no meaningful relationships.

GERDA, fourteen, came to this country with her parents in 1938. Her mother was committed to a mental hospital in 1939, and as a result Gerda became depressed and hostile toward the social worker. She was delicate in appearance and timid, quiet and pensive. Referred to the group through the efforts of Corinne who asked if she might bring this “lonely little foreign girl.” As the family was known to the agency, she was invited to join.

RACHEL, fourteen, was referred to the group by the social worker because she was friendless and lonely. She was not disliked but was not sought out as a com- panion. The social worker felt the girl needed assistance because she failed to re- spond in office interviews. The agency was unable to obtain information that would throw light on the girl’s difficulties.

HESTER was almost sixteen when the group was formed. She was referred because earlier the agency records described her as a self-conscious, timid girl, who found it difficult to form social contacts. The recreational interview indicated that she was sophisticated and rather well-adjusted. Accepted for observation, she dropped out after two meetings.

SARAH, fifteen, was referred to the group because of inability to establish good relationships with either individuals or groups. Selfish, grasping, uncooperative and aggressive toward other children, especially girls, she always managed to be the center of attention by boasting loudly and forcing her plans and ideas on the group. Since infancy she had lived in an environment of family discord, frequent separations, and had witnessed physical abuse of the mother by the father. The intense sibling rivalry was reflected in her relationship outside the home.

RHEA, fifteen, presented an awkward adolescent appearance; tall, ill a t ease, with a somewhat depressed expression. She was apathetic and found it difficult to take part in activity or conversation. Although she was a member of the Com- munity Center and had been to camp, both reports indicated that she was shy, had no friends, and made poor adjustment. (This behavior persisted although she had been to this camp for three summers.) Separated from her brother and father, Rhea’s life with her stepmother no doubt contributed to her insecurity and unhappiness.

It had previously been decided that the meetings should not be in connection either with the family service agency or the psychiatric clinic, but in the Jewish Community Center. It was hoped that by holding the meetings there, the girls could enter into the regular group activities of the Center as they became ready to do so. The group was accordingly provided with a large room exclusively devoted to this program. There were few furnishings in the room and complete freedom for its use. On the same floor was a large game room for adolescent girls and boys,

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Meetings were scheduled to be held weekly on Tuesday afternoons at four o’clock. It was agreed between the girls and leaders that the meetings should last an hour and a half. The project continued for eight months, when it was taken over by the Community Center group worker.

For the first meeting of the group, material for crafts and simple games in which the girls had previously expressed interest was available. There was no or- ganized program of activities, the girls being permitted to do as they pleased, the leaders being there to assist them. All attended the first meeting, but three of the shyest arrived a half hour late. As each girl entered the room, she completely avoided the others, and there was no conversation. Each girl sought some direction from the leader whom she had met a t the clinic for the recreational interview. Each became absorbed in her own particular interest.

The tone of the first meeting was charged with formality and stiffness, with no evidence of group feeling. A half hour passed before any of the girls spoke to one another, and then only when the situation was quite unavoidable, such as “pardon me.” Each sat stiffly with her eyes glued to her work. When one raised her head to look around and felt herself observed by the leader, she quickly dropped her eyes in guilt. The only interpersonal communications were between leaders and girls, and it was apparent the girls wanted to gain as much praise as possible. There was a sense of subtle, implicit competition. During the second meeting, one girl raised her eyes for an instant and asked another girl what school she was attending. A few more daring ones took up the subject with other members of the group. The leaders joined the conversation and gradually drew in some of the shyer girls in this rather innocuous subject of mutual interest.

A t approximately the eighth meeting, i t was noted that some of the girls began to cluster about in groups of two or three. Interest still centered about individual crafts but there was some conversation among the girls. As a matter of fact, one or two felt sufficiently free to call across the table or wander about the room and borrow tools. They began to pass comments on the projects of others; a few even offered suggestions that the objects being worked on could be used for personal adornment. It was about this time that the girls spontaneously asked for assistance from the leaders. Until this time, they had struggled with their individual projects, often obviously frustrated but unable to ask for assistance. Some wanted to come earlier and stay later; three began to walk home together.

For four and a half months the girls continued to work with crafts without any indication of desire for other activities. Feeble attempts to organize met without success. However, greater enthusiasm while a t work was observed. Members of the group offered original suggestions and the crafts were no longer merely a prop, but a means of personal satisfaction and self-expression.

Several weeks later the leader noticed the beginning of a unified group feeling and a growing restlessness with the individualized tasks represented by crafts. Games were introduced which stimulated small groups. Especially successful was an electric contact quiz game. Not only did i t offer the interest of manipulation of the device but it served the purpose of bringing the girls together by having one ask the question and the others offering answers. Those who did not wish to par-


ticipate continued their hand work. Other games such as parchesi, lotto, big business and monopoly were introduced. I t was interesting that these games are typically used by younger children. The girls began to form small groups. To have the entire group participate in some game was a rarity. A typical meeting found some girls working with clay, some painting or doing handcraft, while others played games, particularly of the table variety. Despite the varied activities, there was discussion and conversation between all members of the group.

After five months of meetings, the girls openly sought the approval of the adults in the group. At the same time an increasing desire to make their own plans was noted and encouraged. An idea for having a party seemed to have originated spontaneously. It was decided to plan a program which would be a surprise to the leaders. A committee was selected by the group to write and produce a play. Other committees were chosen to purchase food and serve refreshments. The leaders found it necessary to take an active supervisory role in all the planning and purchasing because the girls were so unrealistic. The content of the program, however, was entirely in the hands of the girls.

The play involved much killing and inhuman characters of zombies. Some of the girls gained much emotional release by portraying such roles as the killer or the corpse, while others gained vicarious pleasure from watching the performance even though they could not participate actively.

It was interesting to note how the various activities of the girls reflected their emotional conflicts. Rhea was disturbed in any games involving money, i. e. monopoly. She lived with a stepmother who had separated from the father after a long period of disagreement. The father never sent any money for her of his wife’s support but gave it grudgingly when Rhea came to beg for it. The leaders did not deal with this problem directly since the information about the girls had been obtained from the case worker without the girl’s knowledge. We were there fore frequently unable to utilize such opportunities within the group itself. This was only possible when the girls sought individual assistance from the psychiatric social worker in her office.

Anna, recently placed in a foster home, similarly indicated her inward feelings while she played parchesi. She continually reached “home” before she had completed the preliminary steps. This mistake was repeated several times. The group became impatient and insisted she follow rules. When tension between Anna’s anxiety and the group’s impatience mounted, the leader sought her out for some individual attention. When leader commented that she appeared confused about the foster home placement, which the girl had recently revealed, Anna grasped the opportunity to discuss the matter further. She was given an appointment with the leader a t her office in the psychiatric clinic. This interview was held at a time when there was a change of social workers a t the placement agency and was per- formed with their complete cooperation.

By this time some group feeling had developed and some of the girls felt free enough to bring up for general discussion problems facing adolescent girls, i.e., insecurity with boys and groups, going steady, dates, make-up, etc.

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I t was after a group discussion of petting that Judith showed indications of wanting individual help. She had been “messing” around with clay for several weeks without producing anything. Her early history of difficult toilet training seemed to have a direct correlation with her selectiqn of clay as a material. That she was gaining some satisfaction from the mere manipulation of this material cannot be denied. Clay seemed to be used also as a tool to reduce tension while she discussed her problems. The manner in which she used the material to gain contact with the leader was interesting. She picked up a piece of clay, engaged the leader in conversation, and gradually edged to the far end of the room. Thus Judith utilized this opportunity to discuss the question of petting on a More personal basis. For three meetings the leader spent part of the time following through some of the problems Judith wished to discuss. To other members it appeared that she was merely getting some assistance with the work at hand. It was not until Judith had settled some of the questions which had been troubling her that she was able to produce the article she had been making-an ash tray.

After six months of weekly meetings, the girls completely discarded the crafts in favor of social activities. As it was drawing close to the end of the school term, plans for the summer became a general subject of discussion. Shirley suggested that it would be fun if the group went to camp together having one of the leaders as counselor. The idea was accepted with enthusiasm. This led to other suggestions about hikes, picnics and parties. The idea finally resulted in a two-week camping experience on a small ranch. All but two of the girls stayed the full two weeks. Sarah and Rhea, unavoidably detained, joined the group for the last week.

Camp offered an added opportunity for growth of group feeling. Although some girls had previously been to camp, this situation offered something decidedly unique in the experience of group living. The plan that one of the leaders go along with the girls as counselor did not materialize and another leader headed the group in camp. The recreational therapist joined the group for four days. This was of value because it afforded the camp counselor an opportunity to talk over her problems in handling the girls with the visiting leader who was able to observe the girls’ adjustment in this new setting.

Upon return from camp, the girls decided they wanted to organize in the form of a club. The varying tempo of development of the different members made the election of officers interesting since those who had moved more rapidly took their rightful places as leaders. The entire election was in the hands of the girls and balloting was secret. The girls felt guilty because Anna, who had openly coveted the position of treasurer, was defeated. Anna showed her resentment by not returning the following week. The newly elected president discussed this situation with the group and the girls admitted Anna had been defeated because she was disliked. The leaders utilized this opportunity to offer some interpretation of Anna’s behavior and the group’s reactions to her.

During the following meetings an entirely different atmosphere was evident from that of a few months earlier. Whereas formerly the general attitude seemed to be that of each girl grasping some pleasure or satisfaction for herself, it was now


replaced by a thoroughly cooperative spirit. The girls decided to call themselves the “Friendly Club.” They chose club colors and spent several meetings deco- rating the room and painting the furniture, each contributing her specific talents. When completed, there was quite a transformation from their former colorless surroundings.

It was suggested by Sarah that the club have an open meeting to which outsiders might be invited. Mildred asked if by outsiders she meant boys. She and Corinne seemed rather frightened a t the idea of having boys. A final decision was made to invite girls, with ultimate plans for mixed meetings. The group assumed complete responsibility for the plans, but asked if they might consult the leaders. When the meeting actually took place, Sarah unexpectedly brought two boys. Surprisingly enough, all the girls accepted the visitors with poise; the boys were completely a t ease and joined in the fun. The mutual competition for the attention of the boys appeared friendly and gay. Only Mildred, who on her own initia- tive came prepared to sing and tell off-color stories, protested their presence. She was told she need not perform. However, when the time came for her part in the program, she carried it off triumphantly, off-color and all. Not only was this behavior in sharp contrast to her former meek and inarticulate self, but her personal appearance was markedly changed. She was clean and neat although poorly dressed, and wore quite heavy make-up. Her eyebrows were plucked, her nails, formerly bitten, were long and brightly colored. Her hair was elaborately curled to emphasize the dramatic change.

At this meeting two new members were voted into the group. One was a somewhat disturbed girl who had previously been referred for membership by the Community Center. This girl applied for membership about five months earlier and had been turned down by the girls. They rejected her vehemently because she was “boy-crazy.” That they accepted her membership a t this time is an indication of the growth of the group. The other new member was a friend of Anna’s.

When the girls began to demand more evening activities and outings, we felt it was the psychological moment to approach them regarding the transfer of the group to a recreational worker in the regular Center program. Prior to our final decision to transfer the group, the psychiatric social worker again saw each girl in order to determine the present status of her social adjustment. By this time all girls had begun to participate in some of the regular group activities provided by the Community Center where the group had been meeting. It was found that all were now members of the Center, whereas earlier, only three had possessed nominal memberships obtained for them by the agency. All but two girls had several extracurricular activities a t school. In addition, many of the girls were now attending parties, often together. Most of the group were attending dances with boys and some had begun to double date.

Although the possibility of the shift had been under discussion for about a month, the last meeting was interesting. The girls indicated awareness that this had been a special project. One expressed the hope that the new leader would understand them as they felt they had been understood in this group. The leaders discussed the progress made by the group during this eight-month period. The


girls themselves felt they were ready for the “next step.” The president of the club called the psychiatric social worker a week later to say they had been successful in securing a group leader for the club. They were planning a party and would like to have the former leaders attend.

To summarize the growth shown by these girls, we are briefly describing the course of development of two. One girl needed only participation in this group to gain for herself sufficient growth for subsequent adequate social adjustment. The other girl gained little from her participation in the group until she utilized the individual interviews, which were in turn made possible only through her original membership in the group.

At first, Corinne gave the impression of being a “little old lady” both in attitude and behavior. She was prim, meticulous, without humor, and very com- pulsive. She finished all the projects started by the group, did a perfect job of each thing, measured accurately, worked carefully and cleaned up thoroughly after each meeting. This pattern she followed for the first five months. Her ability to learn quickly and do good work was utilized to help her relate to the other girls. She became assistant to the craft leader, and willingly aided those who needed special help. She was overly conscious of dirt and disorder, and on one occasion spent an unhappy afternoon because she got a small spot on her slacks-slacks which she wore under pressure from the group. She had resisted adamantly a t first when the group suggested wearing slacks or shorts on a picnic. She always objected to doing anything she believed to be not strictly feminine.

She never mentioned boys herself and blushed furiously when the subject was brought up by other members of the group. During these talks Corinne was observed concentrating intently on her craft as if completely divorced from what was going on. She could not join in group singing and looked uncomfortable during all group performances. These performances were originated by the group and perhaps did not meet Corinne’s standards of propriety. Any group discussions or cooperative endeavor frightened her. It seemed to us that she overcame this anxiety by watching the interaction between adults and the group itself. She eventually became friendly with one of the shyest girls, was well liked by all the members, but never became closely associated with any of the others.

Soon much of her excessive primness began to fall away, she moved freely about the room, laughed and talked with the girls and joined in group games. Her appearance became more of the adolescent girl than that of a child. Moderate make- up appeared, and she chattered about clothes and hair-do’s. She began to walk home with some of the girls and to plan outside activities.

Corinne’s development can best be described by the following incidents. After eight months, the girls decided to repaint the furniture. Corinne lent suggestions as to color and surprised everyone by putting on an old skirt and sitting on the floor, painting with apparent enjoyment. Spilling a little paint on herself was unavoidable, but she took the disaster with ease. She simply asked the leader how to get it off and continued with the job. About this time Corinne’s mother dropped by to see one of the leaders to thank her for the assistance given the girl.


She described an entirely different Corinne. She said the girl was happy, carefree, sang around the house, entertained friends a t home and went to other homes in the neighborhood. Formerly when her father teased her about boys she blushed and left the room in anger, now she smiles and replies, “Which one do you mean, Tom, Dick, or Harry?”

She joined a badminton class a t school and took dancing a t the Community Center where she was now a member. There were several conferences between case worker and group leaders. Equally important with group participation in assisting this girl was the intensive, excellent work with the mother by the family case worker. The mother was not only helped to greater freedom herself, but was prepared to accept the changes in Corinne.

Particularly in the case of this girl, crafts were important not only in helping her through tense situations, but in drawing her out and offering ego satisfaction. Also, the permissive attitude of the adults and the freedom of the group members offered her an experience unlike that in her home situation (prior to the work with the mother). The ability of the other girls openly to discuss adolescent problems as well as interest in their personal appearance provided an incentive for her to be more like them.

Although referred for membership in the group, Evelyn actually entered two weeks late, having found it difficult to arrange for the initial recreational interview during the time when these were being held. All of her behavior showed insecurity. She was aloof, gave the girls the impression of being stuck-up, verbally deprecated all of their activities, and refused to participate herself. She clung to adults, was ingratiating, but continued coming to the group meetings. She gave the impression of being stupid and dull, although previous testing yielded an IQ of a t least 100. In games involving money (monopoly) there was much emotional blocking and she could neither give up what she had nor bargain for more. Her psychology could conceive only of ten dollars, not a thousand. For instance, when offered a generous price for her holdings, she always insisted upon receiving ten dollars more. She was so tense and unsure in personal relationships that she could not even add or subtract the simplest sums, nor could she participate in simple games. It was only after a long period of teaching by the adult that she was able to take part in a game like lotto.

Because of this apparent stupidity, most of the girls openly made fun of her, calling her dumb, maliciously repaying her for her “snobbish” attitude. After about four months in the group she attended a Community Center picnic where she was completely ignored by the other girls. According to the leader, she finally related herself to much younger children. She refused to join the next outing offered by the Center.

In crafts, Evelyn was fearful and could not be drawn into participation. Finally, after long observation and when a friendly attitude toward the leader had developed, she agreed to start something. She selected a leather belt which required only mechanical putting together and no ingenuity or imagination. The leader encouraged this project, feeling it held no possibility of failure, only achievement and satisfaction.


The leaders were aware that before Evelyn could achieve an adjustment within the group, individual assistance would be necessary. After group discussions of cummon adolescent problems, the girls were advised that they were welcome to come to the office for further discussion. Evelyn was finally brave enough to come to the office with another girl. She asked to see the leader, but was evidently too frightened to face her across the desk and left without an interview. A week later she returned and was able for the first time to discuss those problems which had caused her anxiety for many years. Two of her greatest problems were her father’s mental illness, its possible hereditary aspects, and her confusion regarding sex. During this hour she seemed to gain some release, looked brighter, appeared happier, and expressed a desire to return. Unfortunately, it was necessary for her to leave for camp the following week.

I t is interesting that for the first time she was able to make a good adjustment at camp. Although this was impossible before, she now identified sufficiently with the girls to participate in their camp activities. She began to pay a good deal of attention to her appearance, arranged her hair in various styles, joined in hikes and games, and made several articles in the craft class. There were periods when she enjoyed being alone and would go off by herself, reading a book or just daydream- ing, but did not appear unhappy. Her attitude became so changed that the girls accepted her, and she became quite popular with the entire camp.

On return from camp she did not return to the group or the office. There is a possibility that Evelyn felt guilty about the material she had given in her individual interview and was therefore mailed an appointment for an office interview. She came and looked lovely, with make-up well applied, and attractively dressed. She talked enthusiastically of a birthday party she had attended, and other social activities. She did not wish to return to the group because she was now sixteen and felt too grown up to associate with the other girls. Evelyn is mature physi- cally and we felt that this was a realistic objection with which we agreed, and did not urge her return.

During this and the following interviews, Evelyn continued to talk of her problems. She sought assistance with vocational planning and it was thought advisable to refer her back to the worker a t the family service agency. Evelyn felt she could now talk to the worker and indicated no traces of insecurity in the transfer. It has since been learned that she was referred to the Vocational Guid- ance Bureau, kept her appointment, and responded well to the service. She is also seeing the family worker.

Prior to her participation in the group, it had been impossible to reach this girl in formal office interviews. In the group she could observe adults and their attitudes toward other girls, and their interest in helping the girls with their problems. Her difficulties were such that release from inner tension through individual help was necessary in order to free her toward a better adjustment. It is possible that the individual interview kept her from returning to the group, but it must be kept in mind that our major interest was in assisting the individual girl rather than in preserving the group.

The foregoing description of the highlights of an eight-month experiment in


the treatment of a group of neurotic adolescent girls furnishes excellent material for the discussion of the use of group therapy carried on concurrently with individual treatment outside of the group.

Many factors must be considered in the preparation of such a group both in terms of the setting and the interpretation of the project to its members. It was our purpose to organize this group in order to be able to reach these withdrawn girls for individual therapy, and ultimately to release them for participation in the customary social activities of their contemporaries. Thus, even though special leadership was provided, the project was located in the established Community Center so that the girls could be exposed to and take advantage of the regular activities in that agency.

The preparation of the individual members not only gave them some security in the adults who were to lead the group, but also afforded the opportunity for interpretation as to the nature of the project. The realistic discussion concerning the purpose of the group diminished the anxieties sufficiently so that they were enabled to “come and see.” At the same time, it opened the way for subsequent individual interviews by recognition that their individual problems existed.

The careful selection of members for such a project cannot be overstressed. The deeply disturbed adolescent with acute inner conflict is a poor risk in a group unless there is afforded an opportunity for intensive individual treatment outside of the group. The homogeneity of the group must extend beyond the factors of age, sex, intelligence, and school grade, to include cognizance of both the emotional level and the pattern of behavior exhibited by those being considered.

The fact that the girls came for their recreational interviews indicated that even though they were shy and fearful, they were motivated in the direction of emotional maturity. Yet, the manner in which they entered the group suggests the formation of a class a t the nursery school level of emotional *development. They literally had to be led by the hand of their mothers. In this instance the leader who interviewed them took on a maternal role, suggesting a similar role of the therapist during some phases of psychotherapy.

It can be noted from the description of the first few meetings that there was no communication between members of the group. The interest existed only in the objects absorbing the work energies and in the leaders. Due to their inadequate ego development, they were able to find satisfaction in the idealized ego vested in the leaders, and in that way incorporate sufficient energy to bolster their own egos. In other words, through identification with the leaders, the girls gained a feeling of security.

There are many adolescents who cannot be reached in the formal office interview and who find it difficult to talk of their problems. We found that an approach through their interests offers a tangential approach to their problems when they become ready to discuss them. Through provision of games and craft materials, together with the special abilities of the recreational leader, it was possible to provide a period of time during which the girls could observe before re- vealing themselves.


It was only after they established a degree of relationship with the leaders that they were able to form other relationships within the group, and subsequently outside of the group as well. Since the rate of development of maturity was different for each girl, and varied from time to time, several subgroups were formed within the entire group. The continuance of the project permitted the more deeply disturbed, who moved slowly and cautiously into rapport with an adult, to acquire greater security with the leaders. In time this enabled them to form friendships with other girls.

Through the positive, permissive attitude of the leaders, the girls were able to express ambivalent attitudes toward siblings and adults within the group. The more daring ones gained acceptance from the leaders even though they vented their hostilities directly, while the shyer ones gained release from anxiety through observation of this interplay, eventually freeing them to become more direct in expressing their own feelings. As the girls began to develop interpersonal contacts within the group, the omnipotence formerly vested in the leaders began to diminish. They made their own suggestions about activities, and used leaders as resources rather than authorities.

During the planning and formation of the group we recognized the therapeu- tic benefits of group participation by adolescents, but we also realized that some needed more intensive individual treatment. The nature of a group situation places limitations on the degree of personal interpretation possible to individual members. However, through the slowly established relationship of the girls to the leader, opportunities presented themselves for inviting the girls for private office interviews. The majority took advantage of this offer, coming for from one to seven interviews.

Through the combination of group and individual therapy, the girls were no longer an aggregation of individuals, but a unified social group. The social adjustment within the group was carried over into all phases of their living, so that we found them leading normal social lives. Consequently, it was with security that we transferred them to the leadership of the Community Center.

Regular group conferences were held with the family agency workers for shar- ing of observations and cooperative planning. Through these conferences the case workers were able to reinforce evidences of growth exhibited by the girls in their own family settings. Periodic conferences with the group work agency kept them informed of the progress of the group.

We found that a carefully selected, properly prepared group of shy girls, here- tofore inaccessible to either individual case work or customary group work facili- ties, were enabled through this experience to lead more normal social lives. They became happier and more spontaneous, were freed to seek social contacts with their contemporaries, and achieved greater ease in their family relationships. Finally, those most in need of help were prepared to the point where they were freed to seek continued individual assistance through the family agency and the psychiatric clinic.

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AN EXPERIMENT IN GROUP THERAPY WITH SHY ADOLESCENT GIRLS