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PSYC3082 > Wk 9 - Groups > Flashcards

Wk 9 - Groups Flashcards

1
Q

How much therapy is done in groups? (x3)

A

Australia 2006-7:
41 360 x Psychiatrist services billed as “Group Psychotherapy”
Plus, 91k group sessions provided by allied health professionals in hospitals
(no single data base/relative amounts available)

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2
Q

Group therapy is common in… (x5)

Anywhere that…(x1)

A 
University clinics, 
Counselling services, 
Public and private hospitals, 
Correctional services, 
NGO and charitable services

You get large numbers of people presenting with similar problems

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3
Q

Oei & Dingle (2008) The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders’ was a meta-analysis that included… (x1)
Involving… (x4)

A 
34 studies since 1970
Combined average ES across all outcome measures
Cognitive
Behavioural
Mood Symptoms
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4
Q

Oei & Dingle (2008) The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders’ found… (x3)
Concluding that GroupCBT was…

A

13 studies - GroupCBT vs control, overall: average effect size = 1.10 (pretty large)
21 (uncontrolled) studies - post-treatment scores with pre-: average ES = 1.30
Average ES > 1 vs average psychotherapy ES = .82
Better than controls, and comparable with other treatments

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5
Q

Group CBT has been shown to be effective for… (x10)

A 
Anxiety disorders
Social phobia
Substance abuse
Psychosis
Depression in at-risk teens
Marital and parenting
Health - quit smoking, chronic pain, cancer, eating disorders
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6
Q

Why might groups be especially helpful for eg social phobia? (x3)

A

Very normalising to be in company of those facing similar issues,
Gives you immediate exposure therapy,
Cognitively – being in group gives more people to generate more possibilities and help you challenge maladaptive thoughts

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7
Q

How is the finding that 30% of therapeutic effectiveness is down to the therapeutic relationship translate to groups? (x2)

A

The alliance can be with the group leader,

Or between members

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8
Q

What are some egs of contributing factors to ‘extra therapeutic change’ (that makes up 40% of therapeutic effectiveness)? (x6)

A 
Client variables and extra-therapeutic events 
eg Ego strength
Motivation
Complexity of disorder
Current stressors
Social support
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9
Q

What are 5 key concepts in group therapy?

A 
Group cohesion
Group climate
Therapeutic alliance (working alliance)
Therapist empathy
Engagement
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10
Q

What is group cohesion/group climate in the context of group therapy? (x3)

A

The sum of forces acting to pull individuals toward the group,
How much it is a unit that forms and works together to
Accept and be helpful and supporting toward each other

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11
Q

What are the arguments FOR group cohesiveness in group therapy? (x2)

A

Yalom - Cohesion is “… a precondition for other therapeutic factors to function”
Butler & Fuhriman – Cohesion is the “bedrock of the group experience

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12
Q

What does Yalom give as 5 egs of the 11 therapeutic factors of group therapy?

A 
Cohesion (number 1)
Instillation of hope, 
Imparting information, 
Altruism, 
Catharsis
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13
Q

What are the arguments AGAINST group cohesiveness in group therapy?

A

Hornsey, Dwyer, Oei & Dingle:
11/18 studies reviewed showed no relationship btw cohesion and outcomes
Wide variation in definition and measurement of cohesion
Multi-dimensional construct
Self categorisation theory: high cohesiveness may result in less personal expression, dissent….

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14
Q

What was the conclusion of Hornsey, Dwyer, Oei & Dingle (2009) Group processes and outcomes in group psychotherapy: Is it time to let go of cohesiveness?

A

Time to replace it with more clearly defined constructs
Borrowed from small group processes lit,
eg homogeneity, identification, collective self esteem.
Leading on from the notion of freedom of expression and dissent, examined the construct autonomy need satisfaction

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15
Q

What is autonomy need satisfaction? (x3)

A

Coming out of self-determination theory…
Extent to which (group therapy) supports individual’s desire to self-organize experience and behaviour, and
To act in accordance with ones integrated sense of self (Deci & Ryan, 2000)

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16
Q

What was the rational behind Dwyer, Hornsey, Smith, Oei & Dingle (2011) Participant autonomy in cognitive behavioral group therapy: An integration of self determination and cognitive behavioural theories? (x2)

A

Investigated in health, education, parenting, sports, relationship psychology.

Relationship between ANS and psychotherapeutic outcomes unclear

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17
Q

What does autonomy need satisfaction involve? (x3)

A

Active participant in the treatment
Able to make free choices
Able to express ones own ideas and feelings

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18
Q

What was the hypothesis behind Dwyer, Hornsey, Smith, Oei & Dingle (2011) Participant autonomy in cognitive behavioral group therapy: An integration of self determination and cognitive behavioural theories? (x2)

A

Autonomy need satisfaction in group CBT would be related to outcomes, and
This relationship would be mediated by cognitive change.

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19
Q

What was the method in Dwyer, Hornsey, Smith, Oei & Dingle (2011) Participant autonomy in cognitive behavioral group therapy: An integration of self determination and cognitive behavioural theories? (x8)

A 
2 studies (anxiety and depression;depression)
8 full days of GCBT over 4 weeks
Measures collected pre, mid, post-therapy: 
Autonomy 
Cognitions check-list – depression
Depression symptoms 
Anxiety symptoms 
Quality of Life
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20
Q

What were the findings in Dwyer, Hornsey, Smith, Oei & Dingle (2011) Participant autonomy in cognitive behavioral group therapy: An integration of self determination and cognitive behavioural theories? (x3)
Concluding that findings… (x1)

A

Mean autonomy satisfaction increased pre to mid-therapy, then levelled out
Higher Ps autonomy was related to improved outcomes
Relationship is mediated by improvement in cognitions
Supported the tenets of Self Determination Theory in the group therapy context

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21
Q

Johnson and colleagues (2005; 2006) examined which 4 key therapeutic variables in group therapy in which 662 participants from University Counselling Services?
In a study of what three interpersonal dynamics in group therapy?

A

Group Climate, Cohesion, Alliance and Empathy

Client with group leader
Client with other group members
Group as a whole

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22
Q

Johnson and colleagues study in University Counselling service found that interpersonal relationships in group therapy were best explained by a three factor model emphasising…

A

Positive Bonding relationship
Positive Working relationship and
minimal Negative factors (such as empathic failures).

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23
Q

Hoffman et al’s qualitative study of people who improve and deteriorate in group therapy involved… (x2)

A

2 open, process-oriented groups (N=20)

Experienced therapist viewing early sessions was unable to pick improvers from deteriorators

24
Q

What did Hoffman et al identify as common themes of those who deteriorate in therapy (likely to drop out etc)? (x5)

A

Early and substantial disclosure
Open praise of process of group
Expectation of requirement of sharing deep personal information
Tended to share less as group progressed
Main concerns about their family of origin

25
Q

What did Hoffman et al identify as common themes of those who improve in therapy (likely to stick it out etc)? (x6)

A

Caution of group process
More likely to ask for time before joining in group discussion
Accepting credit for positive life changes
Successful soliciting of positive reinforcement from group
Main concern peer relationships
Active engagement by others in group

26
Q

Chronic mental illnesses include… (x7)

A 
Schizophrenia, 
Bipolar disorder,
Recurrent Major Depressive Disorder
Sometimes also PTSD, 
Personality disorders, 
Anorexia
27
Q

What impact do chronic mental illnesses/disabilities have on adults? (x4)
Which contributes to added disadvantage of…(x1)

A

Much less likely to participate in paid work,
Tertiary education,
Social and
Child rearing activities

Social isolation

28
Q

Chronic mental illness can often mean treatment…

A

In the community -
Hospital for accuse attacks
Unable/don’t need individual therapy

29
Q

What is Reclink?

A

17 charitable networks around Australia, that
Link up existing Govt and NGO in an area to pool resources and provide cultural, sporting and recreational groups for adults experiencing disadvantage

30
Q

What are the benefits (mental and physical) of choir singing? (x5)

A 
Improves mental wellbeing 
Increases social bonding 
Reduces cortisol 
Increases oxytocin 
Boosts immunity
31
Q

What were the characteristics of Reclink’s Transformers Choir?

A

N = 21 (57% female)
62% single; 19% sep/div/widow; 19% in a relationship
67% social security only; 19% some paid work; 14% insurance
89% mental health problem
28% physical disability
11% intellectual disability
10% attendance affected by substance misuse
20% referred from Homeless services but ~60% had history homelessness

32
Q

How did Reclink’s Transformer’s Choir rehearse?

A

Once a week (3.5 hours) in community hall
Experienced choir director and two accompanists (piano and guitar)
Music given in form of lyrics
Taught in 4 part harmony
Accompanied or a capella
Support workers and volunteers

33
Q

How were the effects of Reclink’s Transformers Choir measured? (x4)

A

Questionnaire and interviews at start, middle and end of year
Sbout how choir experience influenced Ps’ mood, mental health and wellbeing, social connectedness, other factors

Transcripts read and coded by 2 choir researchers and 2 independent researchers -
Three coding phases with meetings to refine themes

34
Q

What three major (and fourth) themes emerged from data on Reclink’s Transformers Choir?

A

Personal impact
Social impact
Functional outcomes

Time - because meetings happened across time, themes emerged differentially

35
Q

What were the factors of Personal impact of Reclink’s Transformers Choir? (x3)

A

Felt the earliest in process
Positive mood
Finding a voice

36
Q

What were the factors of Social impact of Reclink’s Transformers Choir? (x3)

A

Connection with other choir members
Connection with the audience
Connection with local community

37
Q

What were the factors of Functional Outcomes of Reclink’s Transformers Choir? (x3)

A

Improved routine and structure to week

Improved health and wellbeing

38
Q

What three benefits of the Transformers Choir did Ps report in comparison to previous year? (x3)

A

Mental health was “better” (73%) or “the same” (27%).
General wellbeing during the choir year was “better” (91%)
Social connectedness was “better” (73%)

39
Q

What is involved in the School of Hard Knocks project? (x2)

And its sister project StreetBeat? (x2)

A

Choir and creative writing groups

Basketball rhythm, musical theatre

40
Q

What are the benefits of creative writing/written expression of strong emotions? (x5)

A 
Fewer health centre visits
Lower depression
Lower stress
Less illness-related behaviours
Improved role functioning
41
Q

Explain the Social Identity Approach to health (x4)

A

Social groups structure our self-concept and identity
Give us a sense of meaning, purpose, and belonging, and
Support (financial, emotional, practical), that we are open to giving and receiving.
Influence our attitudes and behaviour, such as engaging in health-consistent behaviours.

42
Q

How have Group Identities been shown to benefit mental health? (x6)

A

Prevent and alleviate depression
Decrease social isolation
Sober groups help with recovery from addiction
Help build self esteem
Help people exit homelessness
Preserve cognitive health in older adults

43
Q

What measures are gathered for the School of Hard Knocks project? (x9)

A

Semi-structured interview at baseline and 12 months
Social network map at baseline and 12 months
Questionnaire at baseline, 6 and 12 months:
Social support
Social identity
Discrimination
Physical health
Mental health
Life satisfaction

44
Q

What are the characteristics of the School of Hard Knocks Ps? (x5)

A 
Mean age 47, half men
Mostly white,
Low education,
Single
Unemployed
45
Q

What mental health issues are prevalent in the School of Hard Knocks Ps?

A 
71% medicated
Mood disorder 50%
Schizophrenia 30%
Anxiety 30%
PD 10%
46
Q

What is involved in making a Social Identity Map (as in School of Hard Knocks)? (x5)

A

Ps list all groups they are members of, on post-its (with size indicating importance of membership)
Rating (out of 10) in top left corner is how positive they feel about being a member of that group,
Bottom right rating is support they receive from others in that group
Lines between groups show connections and conflict, and
Red dots indicate groups where members experience mental health problems

47
Q

What benefits have School of Hard Knocks Ps reported? (x6)

A 
Improved mental health 
Well-being
Increasing Group Identity
Slightly increased group support
Better increase in support from other groups
Less discrimination
48
Q

What is the interim summary on effects of group membership at School of Hard Knocks? (x4)

A

Most Ps identified strongly with the SHK group from the start
Also experienced strong group based support
Most experienced significant improvements in self esteem and mental health
Few who dropped out rated ‘identity with’ and ‘support from’ group lower, and higher group based discrimination

49
Q

What is the Therapeutic community? (x6)

A

Long term residential treatment for people with alcohol and drug dependence
Use the community as the treatment (often with CBT, mindfulness etc):
Social norms
Feedback about behaviour - contingency management/infringement points
Listening and validation
Social support - peer mentoring

50
Q

Are groups (or more groups) always positive? (x3)

A

No - negative ones exist, e.g. using/drinking buddies
Or, unsupportive groups:
Promote negative coping strategies
Don’t offer/give support

51
Q

What are the social and relationship characteristics of members of Therapeutic Community? (x4)

A

60% single/never married
Spent 40% of time alone
40% lived with another with substance problem (r=.46 with discharge for rule violation)

52
Q

What were client perceptions of change at Therapeutic Community? (x2)

A

40% said experienced improvement in substance use and life in general

53
Q

In what ways does social identity change predict outcomes? (x5)

A 
Change in social identity to a “recovery identity” plays important role in 7 month follow up: 
34% in drinking quantity, 
41% in drinking frequency, 
5% other drug use frequency, 
49% life satisfaction
54
Q

Want kinds of group membership s were reported by Therapeutic Community residents to have the biggest impact on Alcohol and Drug Use, (x3)
And on Well-being? (x2)

A

Family
Other A&D
Therapeutic Community

Friends
Community

55
Q

What was concluded from data on social group membership from Therapeutic Community residents? (x3)

A

Memberships and recovery identity play important role in TC treatment, and ongoing recovery
More groups is generally better, esp if clients ID them as part of recovery identity, and supportive of recovery goals
Different types of groups provide different types of support

PSYC3082 (12 decks)

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