Class 5 Flashcards
Efficacy of group therapy is ??? as individual therapy
at least as good
Added benefits of group therapy
Cost-effective
Larger number of therapeutic relationships
Less human resources
Functions of the Group in Therapy
Normalizing Breaking isolation around experience Mutual accountability Developing trust Corrective or new relational experiences Reality testing
Group Therapy Indications
Anxiety disorders (GAD, SAD, Panic, PTSD)
Borderline Personality Disorder –- with individual
Substance Use Disorders
Bipolar I and II – adjunct to meds
Group Therapy Frame
Therapeutic modality Number of participants Composition of participants:homogeneous/heterogeneous - diagnoses, setting, gender, age, race, LGBTQ Closed vs. Rolling Timing, frequency and duration Facilitators Materials
Group Therapy Frame Generally….
8 – 12 participants 1 – 2 hours long 1 session a week, unless Day Hospital 2 facilitators Homogeneous vs. Heterogenous depending on the group
Supportive group
Provide support Sense of cohesion Can be peer-led Vulnerable populations Out of group contact encouraged Community-based Bereavement, cancer, community mental health, AA Homogeneity around an experience Objectives: Garner support around difficult experiences Focus is not long-term change
Psychoeducation & Skills group
Facilitator structures the group
Out of group contact generally discouraged
Rooted in behavioural therapies
CBT, DBT, MBCT, ACT, Stage I trauma groups
Facilitators prepare content and structure
Although there can be common ground, focus is on individual
Individual expected to apply content to their experience and practice skills
Homework between sessions
Objectives:
Learning new information to help understand difficulties
Learn new skills to manage symptoms
Process group
Work through relational patterns ex: personality disorder
Higher psychological-mindedness
Cross-talk
Out of group contact discouraged
Rooted in psychodynamic therapy
Early relationships influence adult relationships
Attachment wounds and disruptions set up a template for interpersonal difficulties
Patterns happen largely outside of our awareness
Facilitators respond organically, no predetermined material
Focus is on interpersonal relationships between patients
Focus is on the Here-and-Now
Group as a whole is the patient
Group as a microcosm for the world
Participants are the main agent of change
No homework
Objectives:
Learning new interpersonal patterns in vivo
Contra-indications to Group Therapy
Severe acting out Acute psychosis and paranoia Active suicidality Inability to tolerate Low motivation Severe incompatibility (e.g. deviant) Language barrier Antisocial Cognitively impaired
Caution if…
Previous lack of success in group therapy
Use of group to seek social contacts
If people are friends outside
Has unrealistic expectations for outcome of treatment
Unable to participate in group task
Low readiness for change
Group Therapeutic Factors Number 1 factor =
Cohesion
Group Therapist’s Role
Mainly facilitative
Ideally, the primary source of change is other group members
Facilitators are responsible for setting and maintaining the frame
Size of group, frequency, composition, materials, etc
Group norms to create safety
Guidelines for group
I-Statements, no advice
Non-judgement
Confidentiality
Accountability
Co-facilitator norms
Effective communication and respect
Different styles, but consistency and positive regard
Are the parents on the same page?
