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Article 60
Perceived Effectiveness of a Well-Being Group With Preschool Children
Abstract: Preliminary qualitative data was collected for a research study exploring a prevention-based group for preschool children called “well-being groups.” The content of the well-being groups incorporated the five domains from Myers and Sweeney’s (2005) Indivisible Self Wellness Model. Qualitative themes emerged from the data collected from parents, teachers, and counselors involved in the group. The qualitative themes reflected an increase in the children’s awareness of emotions, as well as their ability to communicate emotions. In addition, children seemed to present with an expanded understanding and insight of their own well- being.
Keywords: wellness, preschool children, group counseling
Wellness is “a way of life oriented toward optimal health and well-being, in which body, mind, and spirit are integrated by the individual to live life more fully…” (Myers, Sweeney, & Witmer, 2000). Children who thrive and demonstrate mental health are those who not only have the basics of well-being, such as nurturing relationships and physical protection, but also developmentally appropriate experiences to build cognitive, emotional, and social skill levels (Brazelton & Greenspan, 2000). Counseling as a field was developed upon the premise of wellness. Wellness-oriented preventative practices with children have the capacity to increase both self-esteem (Dalgas-Pelish, 2006; Omizo, Omizo, & D’Andrea, 1992) and resiliency (Cowen & Work, 1988).
In one of the earliest documented studies exploring the effectiveness of wellness promotion in children, Omizo et al. (1992) found that children who participated in wellness oriented counseling groups demonstrated greater levels of self-esteem and knowledge of wellness than children who did not participate in counseling groups. Pedro- Carroll (2001) suggested that wellness in children can be promoted by exposing children to protective factors using a scaffolding type process consistent with their cognitive development. Wyman, Sandler, Wolchik, and Nelson (2000) contended that wellness can be best promoted in children by increasing knowledge of protective factors based upon a well researched model of well-being including children’s physical, coping, emotional, and social domains (Myers & Sweeney, 2005). Amato and Booth (1997, 2001) suggested that early family interactions have a significant impact on a child's well-being; therefore, a systemic focus using preventative-oriented psycho-education with parents and other caregivers seems important to ensure a pattern of healthy living is established early in life.
Much of the current literature on wellness-based counseling groups with children has focused on elementary aged children (Dalgas-Pelish, 2006; Omizo et al., 1992). It seems important to also explore the possible impact of wellness-based counseling groups with preschool children. The authors had difficulty finding research that specifically explored wellness and well-being in preschool children. Therefore, the authors developed an 8-week curriculum using well-being groups to address prevention practices with preschool children. This curriculum was developed based upon the five domains of wellness in the Indivisible Self Model (Myers & Sweeney, 2005).
A family systems framework was also included in the well-being groups. A letter was sent home to parents each week describing the goal for the week, possible reflection questions to ask their children, and some activities to do at home to support the weekly goal (an example of a letter home is given in Appendix A). The purpose of this letter was to provide parents with the information that the children were learning, so that they could follow up with them at home. In addition, it was a way for the counseling program to keep parents more informed about what their children were learning. The following is a list of the topics for the 8-week well-being groups:
Week 1: Emotional well-being; “Feelings: What are those?”
Week 2: Emotional well-being; “If I were a feeling….”
Week 3: Social well-being; “What does it mean to be a friend?”
Week 4: Social well-being; “Sharing”
Week 5: Physical well-being; “How is exercise good for me?”
Week 6: Emotional/social well-being; “Expressing myself”
Week 7: Coping well-being; “What do you do with the angries?”
Week 8: Well-being overview; “How do I take care of myself?”
The well-being groups were conducted at a laboratory-based preschool located at a western university. The well-being groups consisted of six groups of 5-8 children per group. The groups were led by second year marriage and family counseling students as part of their Advanced Family Counseling course. After the groups were conducted, a parent letter was sent home to describe the theme for the week. Included in the letter were additional activities for the parents to do at home, as well as follow-up process questions for parents to ask their child. To determine the perceived effectiveness of this 8-week preventative group, qualitative surveys were given to parents, teachers, and counselors exploring their thoughts, feelings, and behavior with regard to the children’s learning and experiences in the well-being groups. The focus of this study was to develop an understanding of the perceived impact of an 8-week wellness-oriented group with preschool children.
Method
Qualitative, phenomenological methodology was used to investigate the research question, “What is the perceived impact of an 8-week well-being group with preschool children?” Specifically, the phenomenological perspective of Max Van Manen (1990) was applied to this research design. This type of phenomenology attends to the description of a phenomenon of study, but also the interpretation of the phenomenon or lived experience. Van Manen contended that using language to describe the phenomenon is an interpretive course of action by the researcher.
Data Collection
The well-being groups are conducted in the spring semester, and the past two years of data collection have yielded 50 qualitative surveys (5 teachers, 36 parents, and 9 counselors). Data collection has consisted of a qualitative, open-ended electronic survey given at the conclusion of the 8-week group experience. The following questions were used for the study. They were adjusted slightly depending upon if the survey was for the parent, teacher, or counselor. Question four was only for parents.
In what ways, if any, do you believe your child’s understanding of well- being has changed as a result of being in this group?
What do you believe is the most important thing that your child learned from this group?
What changes have you seen in your child that you might attribute to being in this group?
How did you use the parent letter?
What else seems important for us to know?
Data Analysis
The researchers used Van Manen’s (1990) hermeneutical approach to analyze data. Responses to qualitative surveys were analyzed for phenomenological themes. According to Van Manen, experiences can be uncovered using three methods of data analysis: the holistic approach, the selective or highlighting approach, and the detailed or line-by-line approach. Data analysis for this study utilized all three methods to determine themes that described the perceived impact of the well-being groups with preschool children.
Trustworthiness Procedures
According to Maxwell (2004), the key to validity within a qualitative framework pertains to potential threats to researcher interpretation as it pertains to the phenomenon. Van Manen’s (1991) phenomenological methodology does not call for the researcher to take a scientific, bracketed approach to the phenomenon of study, rather, Van Manen proposed that “To establish a strong relation with a certain question, phenomenon, or notion, the researcher cannot afford to adopt an attitude of so-called scientific disinterestedness” (p. 33). To increase trustworthiness of this study, the researchers chose to triangulate the source of the data by collecting it from parents of the children, the teachers in the preschool classroom, and the counselors conducting the groups. Additional trustworthiness procedures included prolonged engagement through a 3 year study.
Results
Two years of data have been collected from two cohorts of preschool children participating in the well-being groups. To understand what the perceived impact of the groups has been, parents, teachers, and counselors were asked to answer questions about their observed experience of the children’s participation. Data was coded into themes for each of the three groups: parents, teachers, and counselors.
Parents
Qualitative data has yielded five primary themes with parents: feeling recognition, feeling communication, interpersonal growth, expanded cognition about well-being, and systemic connection. The theme, feeling recognition, included increased awareness and recognition of feelings, particularly more than one feeling at a time. This theme also included understanding that feelings were real and valid. One parent stated “the emotional learning is the most important to me (as a parent) and I think what was most helpful for my child at this age.”
In addition to feeling recognition, a closely related theme that emerged was feeling communication. Parents not only reported greater recognition of feelings, but also their child’s ability to express his/her feelings more succinctly. “He seems better at identifying and articulating his emotions. He now says ‘I’m sad’ or ‘I’m mad’ in a given situation.” One parent reported a change in behavior with increased feeling communication stating “He hasn’t been lashing out at us as much when things don’t go his way. He is able to express his feelings more freely.” Additionally, this ability to communicate more effectively with regard to feelings, extended to siblings. One parent reported “She talked more to her older sister about feelings;” thus demonstrating, that for some children, the ability to communicate about their feelings was extended throughout the family unit.
With growth in feeling recognition and feeling communication, children seemed to begin to understand how others were feeling and how to attune to the feelings of others. This leads to the third theme, interpersonal growth. One parent stated “she has a deeper understanding of how others are feeling. The other day there was a toddler crying in the store and she went up to him and asked if he was okay and if he needed a hug and wanted to talk about it. She seemed more connected.” Additionally, this interpersonal growth extended to the ability to learn how to participate in small groups, which may expand the communication capabilities of the child. As one parent stated, “I think the most important thing was connecting to her teacher and the other children in her small group. She is usually very quiet and I hear that she came out of her shell more during the groups.”
Due to participation in the well-being groups, another theme emerged—an expanded cognition about well-being and taking care of one’s self. From the information disseminated in the small groups, parents described their children as having a greater understanding of what it means to make healthy choices. One parent reported, “she is making more of an effort to try vegetables and she talks about why vegetables are important for our body.” Yet another parent stated, “She seems more in tune with her body, emotionally, mentally, and physically. She can better describe her feelings, make healthier decisions than she used to without my husband or I intervening to help her make choices.”
A family systems connection to well-being was explored in this study by asking parents to identify how they used the letters that were sent home each week. Two main themes were identified. The first theme was associated with connection, the second with context. With regard to connection, parents reported that the letters provided them with an opportunity to talk with their child about what he/she was learning in the well-being group. One parent stated, “ [the letters] sparked good conversation.” Another parent wrote, “[I] read it and talked about it with my child.” Furthermore, it appears that a greater connection might exist, “…I feel like parents can discover new things about their children and themselves along the way as well.” The second theme associated with the letters home was context. The letters home seemed to provide greater understanding and context for what their child was learning as a participant in the well-being group. As one parent said, “I didn’t try any of the activities suggested, but they gave me better insight into what he was learning so I [could] continue it at home.”
Parents were able to identify specific benefits of their child’s participation in the well-being groups. These benefits included their child’s ability to recognize feeling, communication about feeling, interpersonal growth in the identification of feelings in others, and an expanded cognition about well-being. Additionally, a systematic connection was provided by the letters home, which created a greater connection between the parent and child and developed a context by which the parents were better able to understand the content taught in the well-being groups.
Teachers
With regard to the data collected from the classroom teachers, four qualitative themes emerged, interpersonal growth, community, normalization of feelings and an expanded toolbox. The first theme was interpersonal growth as the well-being groups provided an opportunity for the children to practice their interpersonal skills in a more formal manner. Specifically, teachers reported that the children had better listening skills while in a small group setting and were provided the opportunity to build trust with other adults [the counselors]. As one teacher wrote, “with the small groups they [the children] were successful… listening, taking turns, and exploring the concepts being introduced.” Closely related to interpersonal skills was the second theme, community. Teachers stated that the well-being groups provided an opportunity for the children to experience a caring extended community outside of the preschool. As one teacher wrote, “the children were given the opportunity to interact with different people and build interpersonal skills.”
The third and fourth themes identified through teacher responses were normalization of feelings and an expanded toolbox. These two themes were also closely related. With regard to normalization of feelings, one teacher reported “the children gained an understanding that we humans all share the same feelings, have words to express these feelings, and may express them in different ways.” Furthermore, teachers reported that children were able to expand their emotional toolbox, “the children were given different tools to explore and express feelings and emotions.” Another teacher stated, “[the children] understand more feelings and that you can be more than one feeling at a time.” These teacher responses indicated that participation in the well-being groups were beneficial in that they provided interpersonal growth, an understanding of community, the normalization of feelings amongst the children, and the expansion of the children’s emotional toolbox.
Counselors
The final set of qualitative data was collected from the counselors who led the well-being groups. This data yielded six themes, four of which were related to observations of the children’s participation in the well-being groups and two themes associated specifically to the counselors and their experiences in leading the groups. The first theme associated with the children’s participation in the well-being groups was an increased emotional vocabulary. “Children were able to identify and understand primary emotions connected to his or her wellbeing. This emotional understanding seemed to enable children to verbalize emotion and develop a capacity to indicate where in his or her body emotion may resonate.” Moreover, the mind body work that occurred within the well-being groups seemed to help children expand their ability to identify their feelings. As one counselor stated, “they built an understanding of the connection between body and mind (the last day we talked about how taking deep breath calms them down; to recognize within their bodies that they are angry).”
The second theme associated with the children’s behavior as reported by the counselors was an increased emotional expression. Participation in the well-being groups seemed to help the children connect experiences and events with their emotions, but also seemed to teach them to share feelings with others. One counselor wrote, “children began to share feelings with me before I had given them any prompts.”
A third theme that emerged from the data provided by the counselors was the expanded cognition of well-being of the children. Specifically, counselors identified that the children seemed to have an increased understanding of what well-being is, including feelings, but that well-being was not only about feelings. One counselor stated, “I feel that the children gained an understanding that well-being is not just physical well-being and that there are many different aspects to well-being.” Similarly, another counselor reported, “Children seemed to understand well-being is a multifaceted concept.”
The fourth and final theme associated with the children’s behavior as observed by the counselors was social connectedness. While social connectedness is an aspect of well- being, it seemed to emerge as a theme of its own. The counselors spoke to the learning that seemed to take place in the group format regarding the concept of having friends and adults to share emotions with. One counselor stated, “that their well-being, especially their emotional experience, is important to other people and adults.” In addition, the children seemed to enjoy the group format and even began anticipating parts of group, “the children began expecting and wanting to participant in certain parts of group… during the last group as we reached the ending and were still working on our journals and running out of time to do the “feeling forecast,” one of the children reminded me about doing this.” Additionally, “…we also did deep breathing. They [the children] started looking forward to that and initiating it on their own as a group.” With regard to the enjoyment of the group format, one counselor wrote, “group cohesiveness increased as they were able to listen to each other better.”
Two themes emerged that were associated specifically to the counselors and their experiences while leading the well-being groups. These themes were time factor and trust the process. Time factor is related to the time to see changes in the children. Initially, the counselors reported disappointment in not seeing change; however, over time the counselors recognized that the children were learning. “At first, the children did not seem to absorb any of the information; however, with time I was noticing them referencing material we had talked about and utilized more feeling words.” The second theme was trust the process and referred to the idea that the counselors were unsure about the impact that the groups and their leadership had, particularly in the wake of weeks when group time was chaotic. As stated by one counselor, “at times and even now at the end I second guess if I did enough or if the children were learning, but if nothing else I feel that the groups were fun and that the children had fun too…” An additional benefit to the counselors was the opportunity to learn to trust in counseling in play, “I have tried to have confidence that my group learned more than I was witness to…”
The qualitative data from 2 years was triangulated to establish trustworthiness of the data and represents the data from two rounds of data collection from three groups involved in the experience of the well-being groups. These groups include parents, teachers, and the counselors who lead the well-being groups. While these results are preliminary, they provide seemingly important themes associated with a variety of benefits associated with the participation in well-being groups for preschool-aged children.
Limitations
A potential limitation of this study is that it has only been conducted in an educational setting. It would be helpful in future studies to incorporate preschools in the community, not only a university preschool setting. As a result of this setting, it may be difficult for the reader to generalize these results to a community-based preschool. Also, the study utilized qualitative surveys. While providing a means for parents to write about children’s experiences yielded much data, there was no opportunity for follow-up questions. However, given that parents are busy and had little time to meet, it provided the best means to assess the usefulness of the well-being groups.
Discussion Implications for Counselor Education
The present findings are preliminary and representative of themes that have emerged from two rounds of data collection from three groups involved in the experience of the well-being groups. This research enhances existing research which cites the relevance and need for early preventative wellness programming for children (Cowen & Work, 1988; Dalgas-Pelish, 2006; Omizo et al., 1992).
Several common themes emerged across groups in the data. For parents and teachers, a common theme of interpersonal growth emerged. Both parents and teachers indicated that the well-being group experience provided an opportunity for the preschool children to practice interpersonal skills in a more formal manner than a normal day at the preschool would include. Furthermore, parents indicated that children seemed to gain in understanding regarding how others were feeling and learned to “attune” to that. In addition, parents indicated that children described the groups as fun and enjoyed connecting in a consistent manner with their group members. This theme of interpersonal growth is very consistent with the group research (Yalom & Leszcz, 2005) that reports interpersonal learning as a curative factor of group.
Parents, teachers, and the counselors also spoke to the recognition of feelings and the expanded ability to express and cope with emotion. Emotional regulation is a key skill needed for children entering school years (Gottman, 2001); however, there has been little research that focuses on group programming to specifically address this. Much of the literature has centered on parents being the central force in teaching emotional regulation in children, but teaching emotional regulation requires that parents are aware of their own internal emotional experience (Gottman, 2001; Lunkenheimer, Shields, & Cortina, 2007) which is not always the case. With that said, the group is not intended to replace parent involvement, but rather supplement what parents are already teaching their children about emotion.
Parents and counselors found a common theme related to expanded cognition regarding the idea of well-being. Both parents and counselors described that the children seemed to emerge from the well-being groups with a greater, more complex understanding of well-being. This finding fits well with Pedro-Carroll’s (2001) suggestion regarding using a scaffolding type process when introducing protective factors to children. The well-being groups were designed with a developmental perspective as each week built upon the previous week’s knowledge.
Social connection was also a theme that emerged between all three groups. Teachers spoke to a perceived sense of expanded community that the groups provided the children. They believed that the groups being conducted by the counselors-in-training provided a new community context to the children’s experience. Counselors also spoke to the increase of social connectedness through the experience of the group. They noted that the children grew more cohesive with one another in the group setting. It seems important to note that, again, cohesiveness is recognized as a curative factor in group (Yalom & Leszcz, 2005).
Finally, the parents spoke to the use of the letter home. The results were interesting in that many of the parents found the letter to be both informative and connective. The letters home were an attempt to provide a systemic orientation to the group. In fact, some parents spoke to the good reminder the letter provided for them in terms of their own well-being.
Recommendations for Future Research and Conclusion
Future research would replicate this study in preschool settings beyond the university setting to include both urban and rural settings. In addition, a longitudinal study following the children through kindergarten may be interesting to see how much of the well-being group concepts they retained. To do this it might be helpful to pick 3-4 families to follow longitudinally utilizing a case study format.
Preliminary data was collected exploring a preschool-based prevention group for children called well-being groups. The content of the well-being groups incorporated the five domains from Myers and Sweeney’s (2005) Indivisible Self Wellness Model. An initial search of the literature yielded little research, specifically, exploring the experience of wellness-oriented prevention-based programming with preschool children. The preliminary results of this study suggested that the children in the well-being groups increased emotional awareness and ability to communicate emotions. In addition, the groups seemed to enhance the children’s understanding of what wellness and well-being means even at such an early age.
References
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Amato, P. R., & Booth, A. (2001). The legacy of parents’ marital discord: Consequences for children’s marital quality. Journal of Personality and Social Psychology, 83(4), 627-638. doi: 10.1037/0022-351481.4.627
Brazelton, T. B., & Greenspan, S. I. (2000). The irreducible needs of children: What every child must have to grow, learn, and flourish. Cambridge, MA: Perseus.
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Dalgas-Pelish, P. (2006). Effects of a self-esteem intervention program on school-age children. Pediatric Nursing, 8, 341-349. Retrieved from http://www.thefreelibrary.com/Promoting+cultural+responsiveness+and+closing+ the+achievement+gap...-a0206850823
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Appendix A
Promoting Well-Being: Parent Connection
Dear Parents,
This week during our “Promoting Well-Being Group” we discussed:
Emotional Well-being
We talked about four main feelings: happy, mad, scared, and sad. We used different color Play-Doh to represent the different feelings (happy/yellow, mad/red, scared/green, sad/blue), and each child shared a time he/she experienced each emotion. We used a beach ball to promote more active play, and the children answered questions written on the ball pertaining to the feelings words. We introduced the children to the “Feelings Forecast.” This is a tool we will be using each week during group for the children to be able to express their current emotions and share these with the group.
We want to provide you with some questions to promote discussion of this week’s topic at home. You might consider the following questions:
*When was a time you felt happy today?
*What does your body look like when you are mad?
*When do you feel sad?
*What do you do when you feel scared?
*How do you feel right now?
In addition, we have included some activities to promote our theme this week at home:
Feelings Forecast: One of the things we do weekly is check in with children using a Feeling Forecast. We ask them if they are feeling: 1. Foggy – not sure, 2. Sunny- Happy, 3. Rainy- Sad, 4. Thunder- Mad, or 5. Lightning- Scared. Each child has an opportunity to talk about their forecast for the day. You could easily incorporate this as a go around the dinner table to talk about what the family feeling forecast is.
My Feelings Coloring Page: The coloring page (we provided a coloring page with the letter) provides a way for your child to show his/her emotions in a nonverbal way. If your child is having difficulty verbally naming an emotion, he/she may prefer to color a picture to help you understand how he/she is feeling. This is a great tool to open up a conversation with your child. For example, if your child colors the picture of the “scared” turtle, you might say, “The turtle looks so scared. I wonder what scares the turtle?”
Thank you for this opportunity to work with your child!