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psychiatry shlav alef > chapter 28 group therapy > Flashcards

chapter 28 group therapy Flashcards

1
Q

Transactional Group therapy

A

Eric Berne:

emphasis on here and now interactions

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2
Q

Gestalt group therapy

A

Fredrick Perls:

enables patients to abreact and express themselves fully

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3
Q

Client centered group therapy

A

Carl Rogers:

Nonjudgemental expression of feelings among group members.

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4
Q

Which patients prefer group therapy, and who are more anxious about it?

A

those with authority anxiety will feel more comfortable in a group
those with peer anxiety (e.g. borderline and schizoid) may be anxious in a group setting

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5
Q

types of group therapy- frequency:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A

supportive- once a week

psychanalysis of group- 1-5/w

analytically oriented, transactional and behavioral- 1-3/w

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6
Q

types of group therapy- duration:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive and behvioral- up to 6 months

* psychoanalysis, psychoanalytically oriented and transactional- 1-3+ yrs.

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7
Q

types of group therapy- primary indications:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • suportive and transactional- psychotic and anxiety disorder.
  • psychoanalysis- anxiety and personality disorders
  • psychoanalytically oriented- anxiety, personality dis and borderline states
  • behavioral- phobias, passivity and sexual problems
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8
Q

types of group therapy- communication content:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive- primarily environmental factors
  • analytically oriented- present and past life situations, intragroup and extragroup relationships
  • psychoanalysis- primarily past life experiences intragroup relationships
  • transactional- primarily intragroup relationshp, rarely history, here and now stressed
  • behavioral- specific symptoms without focus on causality
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9
Q

types of group therapy- transference:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive- positive transference encouraged to promote improved functioning
  • analytically oriented- positive and negative transference evoked and analyzed
  • psychoanalysis- transference neurosis evoked and analyzed
  • transactional- positive relationships fostered, negative feeings analyzed
  • behvioral- positive relationship fostered, no examination of transference
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10
Q

types of group therapy- dreams:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supporitve and behaviral- not used
  • transactional- rarely
  • analytically oriented-frequently
  • psychoanalysis- encouraged, and allways used.
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11
Q

types of group therapy- dependance:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive,analytically oriented and transactional: intragroup dependence encouraged.
  • in behavioral and psychoanalysis: intragroup dependence not encouraged.
  • supportive and behavioral: reliance on leader is high
  • transactional: dependence on leader not encouraged
  • in psychoanalysis and analytically oriented: dependence on leader variable
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12
Q

types of group therapy- therapist activity:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive- active, gives advice, stregthens defences
  • analytically oriented- challanges defenses, active, gives advice and personal response
  • psychoanalysis- challanges defenses, no advice or personal response
  • transactional- challenges defenses, active, gives personal response rather than advice
  • behavioral- creates new defenses, active and directive
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13
Q

types of group therapy- intepretation:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive- no unconscious interpretation
  • analytically oriented- unconscious interpretations
  • psychoanalysis- extensive interpretation
  • transaction- interpretation of current behaviral patterns in the here and now
  • in behavioal- not used
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14
Q

types of group therapy- major group processes:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • all but behvioral- reality testing.
  • in supportive- universalization
  • analytically oriented- cohesion, transference
  • psychoanalysis- transference, ventilation, catharsis
  • transactional- abreatcion
  • behvaioral- cohesion, reinforcement, conditioning.
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15
Q

types of group therapy- socialization outside group:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • encouraged only in supportive.
  • in transactional- variable.
  • behaviors, psychonalysis and analytically oriented- discouraged
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16
Q

types of group therapy- goals:

supportive
analytically oriented
psychoanalysis
transactional
behavioral
A
  • supportive- increased adaptation to environment
  • analytically oriented- moderate reconstruction of personality
  • psychoanalysis- extensive reconstruction of personality
  • transctional- alteration of behavior through mechanism of coscious control
  • behavioral- relief of specific symptoms.
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17
Q

therapists role in group therapy

A
  • determine size of group, frequency, patient composition
  • confidentiality
  • set goals
  • preparation of patients
  • determine group processes
18
Q

grup therapy- special considerations and contraindications

A

1) antisocial- unless a group of antisocials
2) depression-do better after establishing trusting relationship with therapist
3) manic- under psychopharmacological control
4) exclude delusional, as can incoporate group in their delusional system
5) aggressive

19
Q

advantages for preparation before goup therapy

A
  • patients continue longer

* less anxiety if well prepared

20
Q

size of group

A

can vary between 3-15, but optimal usually 8-10

21
Q

what are alternate group sessions?

A

groups meet twice a week, once with therapist and once without

22
Q

What are marathon group therapies

A

group meets continuously for 12 to 72 hours.

23
Q

pros and cons of marathon group therapy

A

pros:

  • enforced interactional proximity
  • sleep deprivation breaks ego defences, releases affective processes, and promotes open communication.

cons:

dangerous for those with weak ego - e.g. schizophrenia and borderline.

24
Q

ages in group therapy

A

adults: all ages. Helps with developing and reliving interpersonal situations such as parent-child, brother- sister etc.

children and adolescents: persons their own age group.

25
Q

open vs closed groups

A

open- in and out, not a set amount and composition of patients.

26
Q

role of therapist in group therapy

A

mainly facilitative.

ideally the members themselves are primary source for cure and change.

27
Q

inpatient ve outpatients group

A

sometimes bigger group, high turnover

therapeutic factors: sharing information, universalization and catharsis.

  • discuss conflicts between patients and with staff
  • inerpersonal and socail skills
  • adaptations to hospital

insight: more in outpatient(because long term)

28
Q

self help group

A

homogenous

emphasize cohesion

29
Q

combined individual and group therapy

A
  • this is a particular modality- not augmentation!
  • not attending sessions should be analyzed.
  • same therapist for group and individual.
  • usually8-10 patients.
  • provides additional transferentail reactions for corrective emotional experiences.
  • less dropout rate
  • appears to resolve problems more quickly
30
Q

structured interactional group psychotherapy

A

type of combined therapy.

each weekly session focuses on a different group member

31
Q

psychodrama- role

A
  • Director- most active of all group modalities
  • Protagonist- the patient in conflict.
  • Auxiliary ego- another group member who represents someone in the protagonist’s experience
  • group- some participants, some observers. benefit from identifying with events.
  • spontaneity, especially of protagonist.
32
Q

confidentiallity in group therapy

A

therapist is obligated to confidentiallity, but members are not (but should be encouraged).

33
Q

abreaction

A

emotional and cognitive reliving of repressed material, usually leading to insight

34
Q

altruism

A

freud believed it to be a major factor in group cohesion and community feeling.

35
Q

catharsis

A

expression of ideas, thoughts and reperssed material with accompanied emotional response leading to a state of relief.

36
Q

What is the most important factor for positive therapeutic effects in group therapy?

A

cohesion, the sense of “we-ness”, the sense that the group is working together to a common goal.

37
Q

consensual validation and observation

A

Harry Stack Sullivan (and Trigant Burrow):
confirmation of reality and correcting interpersonal distortions by comparing conceptualizations with other group members

38
Q

identification

A

Unconscious incoporation of characteristics and qualities of another person or object into ego system

39
Q

contagion

A

expression of emotion by one member stimulates awareness of same emtion by another member

40
Q

imitation

A

conscious (as opposed to identification) modeling of one’s behavior after another (role modeling), spectator therapy (patients learn from each other)

41
Q

insight

A

conscious awareness and understanding of one’s own dynamics.
emothional insight higher level than intellectual insight- leading to change

42
Q

univesalization

A

you’re not alone!

psychiatry shlav alef (22 decks)

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