Group Therapy

Question 1

Group Therapy

Irvin YALOM

Answer 1

Yalom is key name for group therapy and 3 stages of therapy:

1. Orientation, Hesitant Participation, Search for Meaning, Dependency: tentative stage of communication, finding out rules and meaning, looking to leader for acceptance and answers.
2. Conflict, Dominance, Rebellion: each member attempts to est. preferred amount of initiative and power and gradually control hierarchy, social pecking order emerges. Criticism, judgemental statements and some hostility towards therapist when they are not the favored child.
3. Development of Cohesiveness: unity, intimacy, and closeness become chief concerns, trust, self-disclosure increase, attendance improves, concern about absent members. This is critical stage.

Therapy group is a social microcosm that provides specific curative factors, instillation of hope, universality, altruism, interpersonal learning, self-understanding, insight, learning, catharsis, group cohesion, family re-enactment, guidance, and identification.

interpersonal output, catharsis, self-understanding, and cohesiveness are most important to members.

family re-enactment, guidance, and identification are least valued.

Question 2

Therapist role in GROUP THERAPY

Yalom

Answer 2

1. Creation and Maintenance of the Group:
   
   1. maintain group cohesiveness
2. Culture Building:
   
   1. create group culture that is maximally conductive to effective group interaction.
   2. implicit/explicit directives to establish bx norms
   3. Technical expert: if a norm is nontherapeutic to use mass group interpretation.
   4. Participant/model: self-disclosure (transparancy) is beneficial if used judiciously and responsibly.
3. Activation & Illumincation of the here and now:
   
   1. ​therapist focuses groups attention to the here/now and to understand the processes happening in the present (process illumination).
   2. “this is your bx, how your bx makes others feel, how bx influences opinions of others, and how bx affects your opinion of yourself”

Concurrent Group and Individual therapy: not beneficial unless there is a crisis

Premature Termination: 10-35% drop out w/in 12-20 sessions

can pre-screen to reduce premature termination and enhance outcomes.

post-selection preparation also useful to clarify misconceptions and unrealistic expectations of members

GOOD Candidates: interpersonal issues, motivated to change, positive view of group therapy, psychologically/verbally sophisticated. Involved slowly and finds peer support and feedback beneficial.

BAD Candidates: incompatibility with group norms for acceptable bx, inability to tolerate group setting, severe depression, withdrawal, paranoia, psychosis, brain damage, sociopathy!