Small Group

Curriculum
For
Healthy
Relationships for
Teen Girls

Jessica McKenna
San Diego State University

Table of Contents
Background &
Research..3
Screening
Instructions.9
Lesson 1: Introduction: What are Relationships?
11
Lesson 2: Hugs & Hitting: Healthy vs. Unhealthy
Relationships ..14
Lesson 3: Conflict: Lets Talk About It
...17
Lesson 4: Communication: Lets Talk About It
.19

Lesson 5: Setting Boundaries: What Is Good For

You?..................................21
Lesson 6: Closing:
24

Appendices ..........................................................
...............................26

Background and Research

School Counselors & Small Groups
As school counselors, it is our job to provide students with assistance in three domains:
personal/social, academic and career. While all of these domains are critically important, I chose
to focus on the personal/social domain which includes a wide variety of topics ranging from grief
to goal setting. The group curriculum that I chose to develop is a healthy relationship curriculum.
School counselors participation in sharing information about healthy relationships with their
students is especially significant since unhealthy relationships can lead to numerous

complications in their students lives. According to the Love is Respect website, Violent
relationships in adolescence can have serious ramifications by putting the victims at higher risk
for substance abuse, eating disorders, risky sexual behavior and further domestic violence
(Silverman, J.G, Raj A., Mucci, L.A., & Hathaway, J.E., 2001).
This topic is important for school counselors to address in small groups because
according to the American School Counseling Associations Position Statements, small groups
can ...help students identify problems, causes, alternatives and possible consequences so they
can make decisions and take appropriate action (ASCA,p.28). Many teens are unaware of what
indicates an unhealthy relationship, which is why it is a critical topic that should be identified
and addressed with their peers. Furthermore, groups can be beneficial because they represent a
...microcosm of a students world in which students can practice new behaviors that are more
constructive or adaptive (Brigman & Goodman, 2008, p.3). By creating a group that encourages
the establishment and maintenance of healthy relationships with other group members,
participants will be well prepared for situations and relationships outside of the group.
Why Healthy Relationships Are Important
Relationships are a crucial part of life. For teens, this is exemplified even more with the
emergence of romantic relationships. While most relationships that teens establish are healthy,
there are many that are unhealthy. According to the Centers for Disease Control and Prevention,
Nearly 1.5 million high school students nationwide experience physical abuse from a dating
partner in a single year (2006).Unfortunately, while physical abuse is one component of an
unhealthy relationship, there are many other factors that make up an unhealthy relationship. The

following curriculum will cover communication skills, setting boundaries, conflict causes and
resolution and the identification of healthy and unhealthy relationships.
Communication skills and setting boundaries are not only important in romantic
relationships, but can be used in friendships and relationships with adults. Teens often have an
issue with setting boundaries because they can feel as though they arent worth it, do not have
the right to say no or have a fear of making people unhappy. Furthermore, they want to be
accepted and liked by others, so creating boundaries become challenging for them (van der
Zande, 2015). As the Office of Adolescent Health states, forming and maintaining friendships
during adolescence can be challenging. Peer pressure good and bad often affects decisions
young people make (Spelling, 2005). Unhealthy relationships are often deemed only
romantic, but students struggle with unhealthy friendships as well.
The connection between students health and education is proven. Students who are in
unhealthy relationships often start to become truant, perform poorly academically, stop
participating in school activities and disengage in extracurricular activities (Not My Kid). What
if school counselors could stop that from happening? The Centers for Disease Control and
Prevention states that Scientific reviews have documented that school health programs can have
positive effects on academic outcomes, as well as health-risk behaviors and health outcomes
which will assist them in establishing healthy habits for the rest of their life (Basch, 2010). By
creating a group that focuses on Healthy Relationships, school counselors are proving students
with lifelong tools that will assist them in their relationships with parents, family members,
friends, teachers, coaches, co-workers, romantic partners and other community members.
Why Teen Girls?

Unhealthy relationships affect everyone. In an ideal world, all students would be taught
the fundamentals of having healthy relationships. Unfortunately, we do have the resources for
that, so I chose to look at the group that is often identified as the victim in unhealthy
relationships, which are teen girls. Are teen boys ever the victims of unhealthy relationships?
Absolutely. However, it is well documented in the media girls not only have unhealthy romantic
relationships but unhealthy friendships too. Movies such as Mean Girls and shows such as
Gossip Girl are not figments of our imaginations; they are a true reflection of the relationships
girls can be involved in.
This curriculum focuses on teen girls because in 2014, 83% of teen girls admitted to
being bullied at school or online (NoBullying). Teen girls who are physically or sexually abused
are six times more likely to become pregnant and twice as likely to get a sexually transmitted
infection (Decker, Silverman & Raj, 2005). Girls also are expected to be highly successful by
all measurable standards while staying in shape and conforming to the traditional model of girls
who are sweet and nurturing which is increasing mental and emotional issues among teen girls
(Thompson, 2005). Brian Soller, Ph.D., an assistant professor of sociology at the University
of New Mexico, recently completed a study in which he states that relationships are

not as important to boys identities and they tend to build their identities around
sports and extracurricular activities (Nauert, 2014).

References
Basch C.E. Healthier students are better learners: A missing link in school reforms to close the
achievement gap. Equity Matters: Research Review No. 6. New York: Columbia
University; 2010.
Brigman, G., & Goodman, B. E. (2008). Group counseling for school counselors: A practical
guide (3rd ed.). Portland, Me: J. Weston Walch.

Centers for Disease Control and Prevention, Physical dating violence among high school
studentsunited states, 2003, Morbidity and Mortality Weekly Report, May 19, 2006
Vol. 55, No. 19.

Decker, M., Silverman, J., & Raj, A. (2005). Dating violence and sexually transmitted
disease/HIV testing and diagnosis among adolescent females. Pediatrics, 16, 272276.
Home | American School Counselor Association (ASCA). (2013). Retrieved from
http://schoolcounselor.org
Loveisrespect | empowering youth to end dating abuse. (2015). Retrieved from
http://Loveisrespect.org
Nauert, R. (2014, April). Psych Central - Trusted mental health, depression, bipolar, ADHD
& psychology information. Retrieved from http://psychcentral.com
NoBullying|Bullying & Cyber Bullying Resources & Advice. (2015). Retrieved from
http://nobullying.com
Silverman, J.G., Raj,A., Mucci,L.A. & Hathaway, J.E. Dating violence against adolescent
girls and associated substance use, unhealthy weight control, sexual risk behavior,
pregnancy, and suicidality JAMA. 2001; 286(5):572-579. doi:10.1001/jama.286.5.572

Thompson, S. (2015). The Effects of Social Pressures on Teen Girls. Retrieved from
www.everdaylife.globalpost.com
Van der Zande, I. (2015). Kidpower Personal Safety: Prevent Violence, Bullying & Abuse.
Retrieved from http://kidpower.org

Silverman, J.G., Raj,A., Mucci,L.A. & Hathaway, J.E. Dating violence against adolescent
girls and associated substance use, unhealthy weight control, sexual risk behavior,
pregnancy, and suicidality JAMA. 2001; 286(5):572-579. doi:10.1001/jama.286.5.572

Screening Students
While this curriculum was designed with high school students in mind,
students as young as middle school could benefit from its contents. All students who are
interested in the Healthy Relationships Group for Teen Girls are allowed and encouraged to
participate Teacher recommendations will be considered, since they have daily interactions with
students and may have more insight about the students relationships than the counselor.
Parent/Guardian recommendations will also be heavily considered, since often they have more
knowledge of what relationship issues their child may be facing, if any. Students who are

interested do not have to be involved in a romantic relationship, since the curriculums lessons
focus on tools that can be useful in both romantic and platonic relationships.
The Healthy Relationship Group for Teen Girls will be publicized throughout
the campus by classroom visits and school-wide announcements. Students will then have the
opportunity to sign-up for the group, but may put on a waiting list depending on the seats
available. Based on the age group of the participants, there will be ten-twelve seats available for
those interested in joining. All students who are interested will be briefly interviewed by the
school counselor to see if they will be positive contributors to the group. This includes making
sure that there are no conflicts between members that may disrupt the group process and
students interested are willing to fully participate and be present. The TAP-In pre-screening
process will be used to help assist in deciding what students will be most effective participants
and make sure that all students are fully aware of the requirements and details of the group
(Appendix A). Once students have been chosen, all parents/ guardians will need to complete a
consent form that must be returned prior to the start of the group (Appendix B). Students who
have been chosen and have completed their consent form may join no later than the second
meeting date of the group.

Goals for the Group include:

Identifying signs of healthy and unhealthy relationships

Determine the importance of relationships
Explore feelings and how they can impact relationships
Develop and practice positive ways to handle conflict
Learn and demonstrate positive methods of communication
Establish personal boundaries

10

Explore resources and options in unhealthy relationships

Lesson 1: Introduction:

What are

Relationships?
Time: 50 minutes
Objective:

School Counselor will assess participants knowledge of group

participants by having participants complete a pre-survey. Group participants
will establish rapport with one another and create ground rules for their
group with the assistance of the school counselor who will define and
establish confidentiality guidelines. Students will be able to define what a
relationship is and identify a variety of type of relationships.

Materials:

Note cards, pencils, Pre-Survey, poster paper, markers, signed

permission slips, chairs set up in circle, white board/white board markers

Warm-Up:
Two Truths and a Lie Have participants write down two true things and one
made-up thing about themselves. The school counselor will read each
students card and the group should try to guess which fact is a lie.

Lesson:

11

1. Welcome students and have them sign-in

2. Have students sit in circle and share with them that this group will be
meeting for six weeks and you are excited to get to know each of them
during this time period. While they will be pulled out of class to attend
group, it is important that they make sure that they keep up with their
classwork and homework assignments. If they fail to do so, their
teacher may refuse to let them attend. Explain that during the six
weeks they will be discussing healthy relationships and unhealthy
relationships. Your hope is that when they are done with the group in
six weeks they will know the difference between healthy and unhealthy
relationships, will be able to identify characteristics of a healthy
relationship, acquire and improve communication skills, learn how to
deal with conflict in a healthy way and be able to set personal
boundaries for themselves.
3. Warm-up Activity (Directions above Note cards/pencils needed)

4. Have students complete the Pre-Survey (Appendix C). Explain to the

students that this is not a test and it is only for you to measure how
much they knew prior to the group and how much they learned during
the group. Stress that the survey is confidential (which means nobody
will know who you are and the results will not be shared). To keep it
confidential, ask that they write their initials and birthday at the top of
the survey in the designated space. Have students work on the presurvey independently and ask all students to refrain from speaking
during this time. Collect surveys as students complete them.
5. Students create rules/boundaries for group. Explain to the group that
confidentiality is a must for the group. No person, including you, should
share what happens in the group with anyone outside of the group.
Explain to the students that there are only three exceptions for
breaking confidentiality which include: if they share that someone is
abusing them, they are harming themselves or if they plan to harm
another person.
Ask for a student to volunteer to write as students

brainstorm group rules. (Markers/Poster paper)

Suggestions:

Respect each others point of view, even if it is different

from yours.
Raise your hand. Your thoughts are important and we
dont want to miss anyones ideas by having several
people talk at once.

12

Confidentiality. Do not use names or other identifying

information when speaking about unhealthy relationships
involving friends or family members.
The stories shared in the room stays in the room, but
share all the educational information learned.
No put downs.
It is ok to pass.
(Retrieved from Center for Healthy Teen Relationships: A project of the
Idaho Coalition against Sexual & Domestic Violence)

When students are done creating the group rules, ask each student to get a
marker and sign the poster that states the group rules. Explain to them that
this is considered a contract for the group to follow for the rest of the group
sessions.

6. Group check-in. Go around the circle and do a quick group check-in

with either a thumbs up or thumbs down to see how everyone is
feeling. If someone gives a thumb down, ask if they would like to share
why. Do not insist they share; they have the right to pass. Make sure to
connect with them again before the end of group or keep them back
after group.
7. Discussion on relationships.
Ask students to give their definitions of a relationship. Explain to them that
the definition of a relationship according to the dictionary is:

The way in which two or more people or organizations regard and

behave toward each other. (Ex. Landlord and tenant)
An emotional association between two people.

The dictionary gave an example of a landlord and tenant; can we list some
other types of relationships? Relationships you may have in your life?
Ask for a student to volunteer to write as students

brainstorm types of relationships.

(Whiteboard/Whiteboard markers)
Examples:
Parents
Boyfriends
Girlfriends
Friends
Teachers
Coaches
Other parents/adults

13

 Co-workers
*Identify what it means to have a boyfriend or
girlfriend and what dating looks like to the students.
Explain to students that they can be in a healthy relationship with anyone in
their life family, friends, teachers, coaches, co-workers, and dating
(boyfriend or girlfriend).
Discussion Questions (If time permits not required)
Who are the people you can have relationships with?
What does it mean to have a boyfriend or girlfriend?
What does dating look like to all of you?
Hanging out with a group?
(Retrieved from Center for Healthy Teen Relationships: A project of the
Idaho Coalition against Sexual & Domestic Violence)

8. Closing- Thank everyone for their participation. Remind them that you
will see them next week.

Lesson 2: Hugs & Hitting:

Healthy vs.

Unhealthy Relationships
Time: 50 minutes
Objective:

Students will increase their knowledge of healthy and

unhealthy relationships. They will be able to explain why healthy
relationships are important and identify at least one healthy relationship they
have.

Materials:

Discussion questions, chairs in a circle, Healthy vs. Unhealthy

Handout, poster paper, markers

Warm-Up:
Pop Culture Relationships: One at a time, participants should give their name
and one fictional or pop culture couple who have a healthy relationship or
unhealthy relationship (must identify whether they think the relationship is
healthy or unhealthy).

Lesson:
1. Welcome students and have them sign-in
14

2. Check-in. Once everyone is seated in the circle, go around and have

students complete a weather check-in.
Explain to students that based on how they are feeling they should
give a weather description. Give an example such as: If I was feeling a
little down, I might say its cloudy today but I think the sun might begin
to shine soon. Students can be as creative as they wish.
3. Review of group rules. (They should be posted in the room for the
entirety of the group). Ask for volunteer/volunteers to read the group
rules aloud. If no one volunteers, feel free to read them out loud for the
group.
4. Review of last weeks discussion. Ask for volunteers to give a quick
review of last weeks activities. (Examples: Created group rules, played
two truths and a lie, listed types of relationships, definition of a
relationship, etc.)
5. Warm-up Activity (Directions Above)
6. Communication Fold the Line Activity- Small group discussion
Ask the students to line up according to the month and date of
their birthday in chronological order or by their first names in
alphabetical order. At the halfway point in the line, have the
students fold the line in half, so each student faces another
student. Begin with the first question. When you are done with
the first question, ask one line to move down to the next student
(repeat this step for each question, so for each question students
talk with a different student). Give students 30 seconds for each
question, or until the conversation dies down.
Discussion Questions:
Who are people in your life that make you feel good about being yourself and
why?

What are the characteristics or qualities you look for in a friend?

Does it matter if the friend is a guy or girl?
(Ask everyone as a group how many thought it mattered? Would
anyone like to tell us why they thought it mattered if the friend was a
guy or a girl?)
Should you look for the same qualities in a boyfriend or girlfriend as in
a friend?
(Ask everyone as a group how many said they would be the same?
Would anyone like to tell us why they thought you should look for the
same qualities in a boyfriend or girlfriend as in a friend? )
How should you treat a boyfriend or girlfriend?

15

How do you want to be treated by a girlfriend or boyfriend?

Can you choose how you want to be treated in a dating relationship?
(Retrieved from Center for Healthy Teen Relationships: A project of the Idaho Coalition against
Sexual & Domestic Violence)

7. Healthy vs. Unhealthy Handout

Have students return to the circle if they have not done so
already.
Give each student a handout (Healthy vs. Unhealthy Handout
Appendix F).
Give the group about 5-7 minutes to complete the handout
individually. Then have them pair-and-share with another group
member to discuss answers. Give them a few minutes to discuss
and then bring the group back to discuss as a group. (This
activity could also be used for role-playing, but the second
session may be too soon and make students uncomfortable).
8. List of Healthy vs. Unhealthy Qualities
Ask for a student to volunteer to be the writer. Ask students,
based on the conversations during this session, what they feel
are qualities of healthy and unhealthy relationships. Remind
them that they can always add to the list in future sessions.
9. Homework: Ask students to write down any examples they see over
the next week of healthy or unhealthy relationships. They do not need
to disclose the individuals, just share the actions that the deemed as
healthy or unhealthy.
10.
Closing-Thank everyone for their participation. Remind them that
you will see them next week

16

Lesson 3: Conflict:

Lets Talk About It

Time: 50 minutes
Objective:

Students will explore topics that make them angry. They will
practice verbalizing their personal anger triggers. Students will work
collaboratively to identify common types of conflict and provide solutions for
these. They will also be able to name at least two healthy and unhealthy
responses to conflict.

Materials:

soft ball or object to toss, What is Conflict Activity Directions

(Appendix G), Tips for Teens: Conflict Resolution Handouts (Appendix H),
seats placed in a circle

Warm-Up: Anger Ball-Toss: Find a soft ball. Have the class stand in a
circle. Begin by completing the sentence, "I feel angry when ..." Ask for a
volunteer who is willing to restate what you just said. Toss that student the
ball. That student restates what you said, then completes the sentence for
herself. She then tosses the ball to someone else, who repeats what she said,
then completes the sentence for himself, and so on.
(Retrieved from TeacherVision.com)

Lesson:
17

1. Welcome students and have them sign-in

2. Review of group rules. (They should be posted in the room for the
entirety of the group). Ask for volunteer/volunteers to read the group
rules aloud. If no one volunteers, feel free to read them out loud for the
group.
3. Review of last weeks discussion. Ask for volunteers to give a quick
review of last weeks activities. (Examples: Identified healthy and
unhealthy qualities in a relationship, worked with partners to describe
unhealthy habits in a relationship, identified unhealthy/healthy
relationships in the media, etc.)
4. Homework: Ask for two volunteers to share their homework. Collect
when done.
5. Warm-up Activity (Directions Above)
6. What is Conflict Activity (Appendix G)
7. Distribute and review Tips for Teens: Conflict Resolution (Appendix
H)
Pair students up and have them create a skit based on the
particular tip assigned to them.
8. Closing- Thank everyone for their participation. Remind them that you
will see them next week.

18

Lesson 4: Communication:

Lets Talk About

It
Time: 50 minutes
Objective:

Students will develop and practice healthy communication

skills. They will understand the importance of communication and will be
able to identify various types of communication.

Materials:

Post-it notes or other objects for Minefield activity, blindfolds,

paper, pens, Ways to Communicate Activity (Appendix I)

Warm-Up:

Minefield (Post-it notes, other objects, blindfolds)

Set up the minefield by placing mines (large paper cups, empty plastic bottles,
cones, soft foam balls, etc.) in many places all over the space.
Once the minefield is set up, divide players into pairs. Create pairs carefully. In
each pair, one person will be blindfolded and will be not allowed to see or talk. The
other person is allowed to see and talk, but is not allowed to touch the other person
or enter the minefield. Have each pair decide which role they want to play and
distribute blindfolds.
Playing the Mine Field Game
As you lead the activity, try to inspire the players and emphasize the importance of
trust and safety. Promote a serious environment.

19

The goal is for each blindfolded person to get from one side of the field to the other.
He or she must safely avoid touching the mines, by carefully listening to the
verbal guidance of their partners.
Give each pair a few minutes of planning and preparation for their communication
strategy. Then, have all three pairs go to one end of the minefield. Once blindfolds
are worn and everyone is ready, say Go! and the activity begins. The blindfolded
person cannot talk; he or she just listens and walks. The guider cant touch his or
her partner, but he or she can speak to his partner and use whatever verbal
strategy he or she wishes.
After a pair successfully reaches the other side of the minefield, swap roles and
repeat the process.
(Retrieved from HowDoYouPlay.net)

Lesson:
1. Welcome students and have them sign-in
2. Review of group rules. (They should be posted in the room for the
entirety of the group). Ask for volunteer/volunteers to read the group
rules aloud. If no one volunteers, feel free to read them out loud for the
group.
3. Review of last weeks discussion. Ask for volunteers to give a quick
review of last weeks activities. (Examples: Identified types of conflict,
tossed the ball to each other and shared what made us angry,
completed role-plays for conflict resolution)
4. Warm-up Activity (Directions Above)
5. Ways to Communicate Activity (Appendix I) (Paper & Pens)
6. Closing- Thank everyone for their participation. Remind them that you
will see them next week.

20

Lesson 5: Setting Boundaries:

What Is Good

For You?
Time: 50 minutes
Objective:

Students will gain knowledge of various types of boundaries.

Students will identify at least one type of boundary that they have for
themselves. Students will be able to express the importance of boundaries in
relationships.

Materials:

paper, pens, Boundaries for Teens Handout (Appendix J)

Warm-Up:

Creating Boundaries

Instructions:
1. Have the participants form 2 lines 10 feet apart and face each other. One
line will be As and one line will be Bs. Pairs will be created with the person
directly in front of them.
2. Tell the As that they are going to walk slowly towards the Bs. The Bs will
stand still and when they start to feel uncomfortable with how close the As
are coming towards them, put their hands up with their palms facing As.

21

3. Emphasize that there is no right or wrong distance, its a matter of

personal comfort. There will be some giggling, but encourage the group to do
this silently and to really pay attention to their feelings.
4. Repeat the activity but mix up the pairs so the Bs get to walk towards a
different person in the A line.
5. After the pairs have done this, ask everyone to return to their seats and
process by asking such questions as:

How did it feel to be

B and to have
the power to
stop the
other person?
How did it feel to be
A and not have the power?
Who has the power
in a relationship to set boundaries?
Weve
been looking
at
physical
boundaries,but what
other kinds of
boundaries are important for us to set?
What are some safe ways to
let
others
know our
boundaries?
(Retrieved

from
Lotus Womens Peer Education Training
Manual,
Center
for Health Training
and Women Organized to Respond to Life Threatening
Diseases (WORLD), 2008)

Lesson:
1. Welcome students and have them sign-in
2. Review of group rules. (They should be posted in the room for the
entirety of the group). Ask for volunteer/volunteers to read the group
rules aloud. If no one volunteers, feel free to read them out loud for the
group.
3. Review of last weeks discussion. Ask for volunteers to give a quick
review of last weeks activities. (Examples: Identified types of
communication, wrote about ways we communicate, played minefield,
etc.)
4. Check-in: Go around the circle and have each student give a number
from 0 being the worst to 10 being the best reflecting how their
week has been.
5. Warm-Up (Directions Above)
6. Ask students to write down their thoughts regarding these questions:
What are boundaries in this school? In this classroom?
How do other people set boundaries for you?
What boundaries have your parents set for you?
How do you recognize when you have crossed a boundary? What
may happen?

22

Are boundaries the same for boys? For girls?

What are some behaviors that kids legally cannot do because of
their age? What boundaries do you have for yourself?
How do you respond if your boundaries are crossed?
How do other people know your personal boundaries?
Do you feel you are in control of your boundaries?
(Written by N.D. Stein, K.Mennemeier, N.Russ, & B.Taylor and retrieved from
Lesson on Relationships for Students in Middle School)

Ask students to share their answers for questions #2, 4,6,8 with someone
they have not worked with yet.
7. Boundaries for Teens Handout (Appendix J)
Distribute handouts and read aloud.
Have students share their thoughts, personal stories and
opinions of the handout.
8. Homework: Have students write down an occasion that they have had
their boundaries invaded
9. Closing- Thank everyone for their participation. Remind them that next
week will be their last session.

23

Lesson 6: Closing
Time: 50 minutes
Objective:

Students will be able to identify healthy and unhealthy

relationships, describe various types of communication, explain boundaries
and the importance of them and provide examples of healthy ways of
dealing with conflict.

Materials:

note cards, pens, computer access, projector, Jeopardy

Template , Post-survey (Appendix C), Group Evaluation (Appendix D),
Parent Feedback (Appendix E)

Warm-Up:

Powerful Words Students will receive note cards and place

their names on them. The counselor will then have the students pass their
cards to the left, with each student writing a positive comment or word on
the card. The card will be returned to the student with positive feedback from
their peers.

Lesson:
1. Welcome students and have them sign-in
2. Review of group rules. (They should be posted in the room for the
entirety of the group). Ask for volunteer/volunteers to read the group
rules aloud. If no one volunteers, feel free to read them out loud for the
group.

24

3. Review of last weeks discussion. Ask for volunteers to give a quick

review of last weeks activities. (Examples: Identified types of
boundaries, discussed how we establish boundaries, shared how we
felt when our boundaries were crossed, etc.
4. Warm-Up (Directions Above)
5. Jeopardy (Jeopardy Template) Play Jeopardy with students covering
the topics of Healthy and Unhealthy Relationships, Communication,
Conflict and Boundaries.
6. Complete Post-Survey (Appendix C)
7. Complete Group Evaluation (Appendix D)
8. Distribute Parent Feedback forms in envelopes to students (Appendix
E)
9. Closing- Thank your students for their involvement, commitment and
participation.

25

Appendix A

TAP-In Process for Pre-Screening

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 topics you might address during screening.
All factors will be considered when it comes time for the final selection. A positive
or negative response to a question does not automatically indicate
inclusion/exclusion 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.

Tell 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.
Participation in the group is voluntary/involuntary.
Tell student what he or she will gain from being in the group

26

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
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
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.
Ask the student about his or her interest and commitment

Pick

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 is interested 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.
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

27

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
(Morganett, 1990) provide direction and information that must be balanced
with what you know about the group, the student, yourself, your professional
wisdom and intuitive reaction.
Retrieved from Missouri Comprehensive Guidance and Counseling ProgramResponsive Services Small
Group Counseling Module
Reference: Morganett, R. S. (1990). Skills for living: Group counseling activities for young adolescents. Chicago:
Research Press.

Appendix B
Dear Parents/Guardian,
Our schools Comprehensive Guidance and Counseling Program includes the opportunity for
students to participate in small group counseling experiences. We will be beginning a group on (date).
Each group will meet once a week for approximately 50 minutes each week. We will rotate the times that
we meet to avoid your student missing too much time from any one particular class. Even though the
small group counseling experience will have a positive effect on your child, the immediacy of classroom
requirements will take precedence over group participation.
The Healthy Relationships for Teen Girls group is designed for high school students who are
interested in what a healthy relationship should look like. We will be determining the differences between
healthy and unhealthy relationships, learning how to set boundaries, improve communication and handle
conflict.
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).
______________________________________, School Counselor
Phone Number: (_____) ______-__________
Email Address _______________________________

28

- - - - - - - - - - - - - - - - - - - -- - - - - - - - cut here and return lower portion - - - - - - - - - - - - - - - Consent for Participation in: Healthy Relationships 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 student to participate in the Healthy Relationships Group.
I do not give my consent for my student to participate in the Healthy Relationships Group.
Parent/Guardian (please print) ___________________________
Phone _________________________

E-mail______________________________________

__________________________________________________
Parent Signature

__________________
Date

Adapted from Missouri Comprehensive Guidance and Counseling ProgramResponsive Services Small Group
Counseling Module

Appendix C

Pre/Post Survey
Initials_________ Date of Birth_________

Section 1:
Consider each of the following actions.
(Please indicate whether or not you believe they are forms of abuse.)
When someone
Not Abuse
Uncertain
Abuse
Slaps you
Drives fast to scare you
Tries to control you
Pressures you to dress a certain
way
Follows or spies on you
Pushes or shoves you
Accepts when you choose to
spend time alone or with family
Keeps you from leaving
Pressures you for money
Pressures you to have sex

29

Calls you names or uses putdowns

Threatens you
Accepts your opinions
Destroys your property

Section 2:
Consider each of the following actions.
(Please indicate whether or not you believe they are characteristics of a
healthy relationship.)
When someone
Not Healthy
Uncertain
Healthy
Asks your opinions
Is very jealous
Respects your friends
Asks how youre feeling
Wants you to spend all your
time with him or her
Trusts you
Tells you when he or she is
angry
When someone
Not Healthy
Uncertain
Healthy
Says he or she will commit
suicide if you break up
Accepts if when you choose
to spend time with family or
alone
Lets you make your own
decisions
Accepts when you say No
Wants to control you
Section 3
These next questions ask how confident you are in YOUR ability to do each of
the following. If you have had a girlfriend or boyfriend, complete the
questionnaire with that person in mind. If you have not had a girl or boy
friend, please complete this questionnaire while thinking of another close
relationship (i.e. family member, close friend, etc.)
How good are you at

Not Good

Okay

Very

30

Good
dealing with important disagreements
openly and directly
openly talking about what you want
creating boundaries for yourself
showing respect to your partner when you
disagree with his or her opinions
telling your partner when you feel hurt or
upset with him or her
controlling your temper when your partner
is angry at you
offering criticism to your partner without
hurting his or her feelings
accepting criticism from your partner
without attacking or challenging him or
her
comforting your partner when he or she is
"down" or "depressed"
controlling your temper when you are
angry or frustrated with your partner
controlling feelings of jealousy
working out "everyday" problems with
your partner
Adapted from National Resource Center on Domestic Violence publication entitled: Expect Respect: A
School-Based Program Promoting Safe & Healthy Relationships for Youth by Barri Rosenbluth.

Appendix
D
STUDENT FEEDBACK FORM
Directions: Please complete the Student Feedback Form after the last group
session.
Name: ___________________________________ (optional)
____________________

Date:

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
______________________________________________________________________________

31

1. Overall, I would rate my experience in the counseling group as a good

one:
= I agree

= Im not sure

= I disagree

2. I enjoyed working with other students in the group

= I agree

= Im not sure

= I disagree

3. I enjoyed working with the counselor in the group.

= I agree

= Im not sure

= I disagree

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

= I agree

= Im not sure

= I disagree

5. If other students ask me if they should participate in a similar group, I

would recommend that they give it a try
= I agree

= Im not sure

= I disagree

Additional comments you would like to share with the counselor:

Adapted from Missouri Comprehensive Guidance and Counseling ProgramResponsive Services Small
Group Counseling Module

Appendix E
(Note: Print on school letterhead & send to parents via student/mail)
Comprehensive Guidance and Counseling Program
Small Group Counseling topic/title:
______________________________________________________
Students Name ________________________Teachers Name
________________________
Date: ____________________________________
Dear ____________________________________,
32

I have enjoyed getting to know your student in our small group counseling
sessions. This week was 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: ______________________________________
Session 6: _____________________________________
Comments from the school counselor about your students progress:

Thank you for your support. Please contact me if you have questions or
concerns.
Sincerely,
Professional School Counselor
Retrieved from Missouri Comprehensive Guidance and Counseling ProgramResponsive Services Small
Group Counseling Module

Appendix F
Healthy vs. Unhealthy Relationships
(School Counselors Copy)
Healthy
Unhealthy
Equality- Partners share decisions
One partner makes all the decisions
and responsibilities. They discuss
and tells the other what to do, or tells
roles to make sure they are fair and
the other person what to wear or who
equal.
to spend time with.
Honesty Partners share their
Dishonesty- One partner lies to or
dreams, fears, and concerns with
keeps information from the other.
each other. They tell each other how
One partner steals from the other
they feel and share important
information.

33

Physical Safety-Partners feel

physically safe in the relationship and
respect each others physical space.
Respect-Partners treat each other like
they want to be treated and accept
each others opinions, friends, and
interests. They listen to each other.

Physical Abuse-One partner uses

force to get his/her way (hitting,
slapping, shoving).
Disrespect-One partner makes fun of
the opinions and interests of the
other partner. He or she may destroy
the others personal possessions.

Comfort-Partners feel safe with each

other and respect each others
differences. They can be
themselves with each other.

Intimidation-One partner tries to

control every aspect of the other
partners life. If the partner doesnt
comply the controlling partner may
threaten violence or leaving the
relationship.
Sexual Abuse-One partner pressures
or forces the other into sexual
activity against his/her will or without
his/her consent
Dependence-One partner feels that
he/she cant live without the other.
He/she may threaten to do
something drastic if the relationship
ends

Sexual respectfulness-Partners never

force sexual activity or insist on doing
something the other isnt
comfortable with.
Independence-Neither partner is
dependent upon the other for an
identity. Partners maintain
friendships outside of the
relationship. Either partner has the
right to end the relationship.
Humor-The relationship is enjoyable
for both partners. Partners laugh and
have fun.

Hostility-One partner may walk on

egg shells to avoid upsetting the
other. Teasing is mean-spirited.

U. S. Department of Health & Human Services

Healthy vs. Unhealthy Relationships
(Write an H for Healthy and U for Unhealthy in each box based
on what type of relationship you believe the statement represents)
(Note: Partner can be replaced by friend, partner, etc.)

One partner lies to or keeps

One partner may walk on egg

34

information from the other. One

partner steals from the other

shells to avoid upsetting the other.

Teasing is mean-spirited.

Partners treat each other like they

want to be treated and accept each
others opinions, friends, and
interests. They listen to each other.

One partner tries to control every

aspect of the other partners life. If
the partner doesnt comply the
controlling partner may threaten
violence or leaving the relationship.
Partners feel safe with each other
and respect each others differences.
They can be themselves with each
other.
Partners never force sexual activity
or insist on doing something the
other isnt comfortable with.

One partner pressures or forces the

other into sexual activity against
his/her will or without his/her consent
Neither partner is dependent upon
the other for an identity. Partners
maintain friendships outside of the
relationship. Either partner has the
right to end the relationship.
One partner feels that he/she cant
live without the other. He/she may
threaten to do something drastic if
the relationship ends.
One partner uses force to get his/her
way (hitting, slapping, shoving).
Partners feel physically safe in the
relationship and respect each others
physical space.

One partner makes fun of the

opinions and interests of the other
partner. He or she may destroy the
others personal possessions.
The relationship is enjoyable for both
partners. Partners laugh and have
fun.
Partners treat each other like they
want to be treated and accept each
others opinions, friends, and
interests. They listen to each other.
Partners share decisions and
responsibilities. They discuss roles to
make sure they are fair and equal.

One partner makes all the decisions

and tells the other what to do, or tells
the other person what to wear or who
to spend time with.
U. S. Department of Health & Human
Services

Appendix G
What Is Conflict?

35

Objective: Drawing on familiar experiences and personal perceptions

students will develop a working definition of conflict and consider what
makes some conflicts worse than others. Students will also complete an
initial assessment survey about interpersonal conflict.
Materials: Newsprint, markers, handouts: "What is Conflict Worksheet"
"Survey About Me and Conflict"
Procedure:
1. Write the word CONFLICT again on the board or on newsprint. Ask the
class what they think of when they hear the word "conflict".
Brainstorm all the words and phrases that come to mind and make a
WEB CHART of responses around the word CONFLICT. You may want to
use different colored markers to write words and phrases or circle
categories of words in different colors when brainstorming if finished
(purple = wars and violent responses to conflict; red = feelings; green
= sources of conflict; orange = negative words which describe conflict;
blue = neutral or positive words describing conflict or words that imply
nonviolent means of resolving conflict).

2. Ask students how they would differentiate the word groupings you have
circled or written in different colored markers. Discuss some of the aspects
of conflict noted in #1 above. Explain to students that we often see conflict
as a negative or destructive experience, rarely seeing disagreements and
differences as constructive opportunities to learn, change, and grow. You
may want to make another web in which you generate words that describe
ideas, feelings, and actions associated with resolving conflict and problem
solving.
Suggested discussion questions:
Is a fight different than an argument? How?
Why do conflicts become violent?
How do you feel when a conflict isn't worked out? Are conflicts always bad?
Can conflicts ever be positive - have good endings?
How do you feel when you've successfully resolved a problem?

36

Can you think of a conflict that helped you learn something about yourself or
other people?
Can you think of conflicts you've experienced that actually improved the
situation in the long run?
Could there be a world without conflict? Why? Why not?
If conflict is a fact of life, if we can't make it go away do what do we do with
it?

Activity: Have students complete Conflict and Me Survey

Conflict and Me Survey

37

1. Most people fight or argue when they:

____________________________________________________________________________
2. Most people fight or argue over:
_____________________________________________________________________________
3. One good thing people get from arguing or fighting is:
____________________________________________________________________________
4. One bad thing about arguing and fighting is:
____________________________________________________________________________
5. People generally respond to conflicts by (list two):
____________________________________________________________________________
6. I fight or argue when:
_____________________________________________________________________________
7. I get upset or angry when other students:
_____________________________________________________________________________
8. I make others angry when I:
_____________________________________________________________________________
9. When I'm talking to someone else who is really angry or upset, the most
important thing to do is:
______________________________________________________________________________
10. When I'm really angry or upset with someone, the most important thing for me
to do is:
____________________________________________________________________________
11. When I'm upset at, mad at, or bothered by another student I can (list three):
______________________________________________________________________________
12. When I have a disagreement or conflict with someone, we can agree to:
____________________________________________________________________________
Excerpted from Conflict Resolution in the High School by Carol Miller Lieber with Linda
Lantieri and Tom Roderick.

Appendix H

38

Tips for Teens: Conflict Resolution

1. Talk to the person directly, dont use other people to speak for
you!
(Its like the game Telephone, by the time the message reaches the other
person, it ends up sounding different than you intended).
2. Dont jump to conclusions!
Hearing the other persons side of the story can help you get the facts and
understand where they are coming from.
3. Listen!!!
Each side needs a chance to express themselves.
4. Use I statements to express your feelings.
I feel sad when you and Jenny ignore me at lunch. I wish you wouldnt do
that.
Begin your statements with I, not You
5. Apologize if you have done something wrong or hurt someone.
Dont be afraid to take responsibility for your mistakes.
6. Brainstorm ideas of things you can both do to prevent this from
happening again.
Find a few you can agree on and follow through with them!

(Adapted from Conflict Resolution Strategies for Teens by Susan Carney;

www.suite101.com)

39

Appendix I

Ways to Communicate
ESSENTIAL QUESTION: What are some ways humans communicate?
OBJECTIVES/PERFORMANCE EXPECTATIONS: Participants learn about
different forms of communication; participants practice different forms of
communication.
SUMMARY OF THE ISSUE: Communication is what we do to give and get
understanding; it is the process of sending and receiving messages.
Successful communication occurs when there is understanding.
Communication can be verbal, using oral language to convey a message, or
nonverbal, including facial expressions, body language, text or written based
language. Sometimes a messages original meaning gets lost in the
translation between thought and the act of communicating it. Teaching
young people how to communicate effectively helps them maintain healthy
relationships, resolve conflicts peacefully, excel in school, and eventually get
and keep jobs.
MATERIALS: Paper Pens and pencils
LENGTH OF LESSON: 30 minutes
PROCEDURE:
1. Begin by playing the game Telephone. Have participants sit in a circle.
Ask one participant to think of a phrase or sentence. Direct them to whisper
it in the ear of the person sitting next to them. Each participant whispers
what they think they heard to the next participant next to them. The last
participant says the phrase or sentence out loud. Ask the first participant if
that was their phrase. Did anything change? Did the message get lost or
changed in translation? This is an example of verbal communication.
2. Now play the game Charades. Have participants get up one at a time to
act out a phrase or sentence without using any words or sounds while the
others guess the phrase or sentence. Ask participants to explain what they
did to communicate their message when they were unable to use words (ex:
facial expressions, body language, gestures). Were others able to guess the
phrase or sentence? Was the message delivered effectively? This is an
example of non-verbal communication.

40

Explain that we all communicate all day long, whether or not we are using
words. Explain that others pick up messages from our facial expressions,
body language, gestures, and general demeanor.
3. Have partners get in pairs. Direct them to communicate hello to their
partner three different ways. If they need help, remind them that they can
use verbal words, written text, their body or a gesture, or even do something
creative.
4. Next have them communicate a feeling to their partner. Give examples of
feelings: sad, angry, happy, excited, jealous, confused, or worried. The other
partner will guess what feeling they are portraying. For example if their
feeling was sad they could say or write I feel sad, make a facial
expression, or show with their body how they feel)
5. Give examples from telephone and charades to demonstrate that
what you want to communicate is not always what others understand.
Explain this is how rumors and gossip spread: someone tells someone a
secret and it gets passed on and it gets changed and distorted along the
way, just as the message did in telephone.
6. Remind participants that being clear and concise in their verbal and nonverbal communication is an important life skill that needs to be practiced.
7. Finish by using non-verbal communication to ask participants to take out
their journals or that youll see them later or that you love them! Have
participants guess your message and then do the action.

Writing PROMPT: How do you communicate most often? How would you
get people to understand you if you couldnt communicate that way
anymore?

RELATED ACTIVITIES: Have participants tell a story about themselves without

using words. Or using only words!

Retrieved from San Diego County District Attorney

41

Appendix J

Boundaries for Teens

Boundary Principles
1. We each belong to ourselves.
I belong to myself my body, my time, my feelings, my personal space, my thoughts,
my spirit, all of me. And other people belong to themselves.

2. Some things are not a choice.

My family, school, coach, and/or employer have rules that I must follow or there will be
consequences. I can speak up but I cannot always control what other people will think,
feel, say, or do. I can set boundaries, leave, or seek help if others harm my health or
safety. I cannot always control whether a situation or relationship at home, at school,
with friends, or at work will get better.

3. Problems should not be secrets.

and neither should touch, teasing, gifts, or favors.

4. Keep telling until you get help.

Getting help can mean asking the person who is creating the problem to change
his/her behavior; talking to someone who is in a position of authority to solve the
problem; gathering with other people to deal with the problem together; asking for
personal support from someone outside the situation completely; or even taking legal
action.

What Makes it Hard to Set Boundaries?

1. Internalized beliefs: not worth it, have no right, dangerous to say no, my role is to
please others.
2. Triggers: emotions, behaviors, thoughts, and words that cause us to explode with
feelings.
3. Longing to belong: wishing to be accepted, loved, wanted, or included by another
person or a group.

42

4. Having grown up in a home where appropriate boundary-setting was not allowed.

Effective Communication of Boundaries With People We Know

Communication and conflict-resolution programs teach people to set boundaries by
talking about their own feelings, the other persons specific behavior that is a problem
for them, and the specific behavior from the other person they want to see. Figure out
what you want! Although you will find ways to state your boundaries in your own words,
practicing with the following model can help you organize your thoughts:

I feel (state your feeling in terms that are all yours rather than attacking the
other person)

When you (state the specific behavior that is a problem to you; try not to use
words like you never or you always)

Would you please (say what you specifically want the person to do)

You might say to a parent, I feel frustrated when you interrupt and sound angry when I
try to explain a problem to you. Would you please listen to me first and then tell me
what you want to say in a regular voice? Or, I feel irritated when you insist on helping
me. Would you please let me do it myself? Or, I feel upset when you yell at me and
look so angry. Would you please just tell me what I did wrong in a calm way? You might
say to someone living with you, I feel annoyed when you use my stuff. Please ask first.
You might say to a teacher, coach, youth group leader, or boss, I feel nervous when
you give me criticism while I am learning something hard for me. Would you please give
me time to get better? Or, I feel upset when you expect me to stay after ____ (school,
work or other activity) because something comes up at the last moment. Would you
please make a plan so that I can finish during our regular hours?
You might say to a friend, I feel irritated when you get upset that I am hanging out with
someone else. Would you please understand that I want to do some things without
you? Or, I feel hurt when you get so mad about a misunderstanding. Would you please
accept that mistakes happen? Or, I feel unheard when you jump in with suggestions
or start telling me about your problems when I am unhappy. Would you please just
listen? Or, I feel sad when you talk (or act) as if I am not there. Would you please
include me as being important?
You might say to a date, I feel pressured when you start making sexual advances
before I feel ready. Would you please ask me first? Or, I feel pressured when you act

43

disappointed because I said, No. Would you please accept my No gracefully? You
might say to a friend, teacher, boss, or family member, I feel uncomfortable when you
make sexual jokes (or other prejudicial sexist, homophobic, racist, etc. remarks). Please
stop doing this in my presence.
As an alternative to I feel, you might say, It concerns me when
Retrieved from kidpower.org and written by Irene van der Zande, Kidpower Founder and Executive
Director

44