Yalom - chapter 13 - specialized formats and procedural aids Flashcards
what is conjoint therapy
client is seen in individual therapy and a different therapist in group therapy.
what is combined therapy
client is treated by the same therapist in group and individual
do private practices used conjointed or combined therapy
combinted
do community mental health use combined or conjoint therapy more
conjoint
what kind of client should seek individual and group x7
the difficult client (borderline or narcissistic), those with a history of SA, grief work, High acuity of SI, those that may drop out, and impulsive clients.
in what way do most individual clients become group members, through combined therapy or conjoint
conjoint
what is a common reason for seeking group conjointly
transference issues
what must be present for individual and group to work together
synthesis of the 2 services.
what are 2 kinds of complications seen in combined/conjoint therapy
1- cross purpose between individual and group due to major differneces in the therapists. 2- individual clients see group as getting less attention as seen in individual so they are discouraged.
What creates synthesis between group and individual
there is an ROI, the 2 collaborate and work together, it is not done to facilitate a level of termination with a difficult client
what should be done if group members recommend individual therapy to another member
it should be prepared to be discussed openly in the group.
how does combined/conjoint therapy reduce drop out x2
1- therapist knows the client well and can provide extra info for proper selection/deselection. 2- therapist can assist in processing things that go in group.
what is the issue for the therapist in combined therapy x3
1- they know everything about everyone. less freewheeling. it is hard to ask questions when you already know the answer. 2- transference and counter transference can get worse. 3- confused boundary lines and confidentiality.
how is group and AA similar x3
use of bonding/belonging, role modeling, interpersonal learning
what are 6 untrue preconceptions regarding the work of group and AA
1- AA don’t use meds or therapy. 2- AA use surrender of personal power to that of a higher power. 3- AA discrouages strong emotion. 4- group neglects spiritualty. 5- group is better than AA 6- group thinks of the relationships in AA as regressive.
what is a major differecence between group and AA
no cross talk is used at AA
what is cross talk
direct interaction between members during a meeting. this is
what are some ways that having a co therapist is best
1- more cognitive range. 2- focus on an individual for one, and the other focuses on the group. 3- able to take vacations. 4- transference is easier to see. 5- male-female co therapy also for further exploration of parental roles. 6- able to work thru countertransference. 7- assist when one therapist is under attack by members.
is co therpay disagreement helpful?
yes
where do issues arise if using co-therapy
due the relationship between the co therapists
what is the most common way for therapists to disagree
theoretical orientation.
what can you do in the pre screening stage to prevent splitting
have both therapists interview potential clients at the same time.
what should co therapists do during the break
talk and discuss and attend to their own relationsihp
how should dreams be interpreted in group
based on the current phase of therapy
what kind of dream is most important about group work
dreams that involve the group. much like dreams that involve therapy.
during video feedback sessions, what do early members watch for
their own images and not to the interactions.
when does video feedback become less useful
later in sessions when the group is cohesive and interactive.
who experiences the most discomfort being recorded
the therapist due to fear of being exposed or ashamed.
what are 3 reasons for group sessions summaries
1- double as a progress note 2- help to keep thigns moving and allow for clients to reintegrate the experience. 3- hones language skills.
how doe having a summary help continuity
it makes the client rethink and rework the session and builds continuinuty in this way as having hte group be present for them after the session.
what should the summary never do
be the penultimate last word in the session or group work.
what is there to say about groups that hae alot of structured exercies
there is less change, what change that does occur doesn’t last very long, but the members did see the tehrapist as more competent -
why does using a structured exercise help a group to see you as competent (Even though the outcomes are poorer)
because it fulfillst he transfrance of what htey think is a leader.
what is the purpose of the structrued exerise
to speed things up in the group = but the group will pay a price for such and not be able to “sit in it.”
do we see resistance as something to work around or through
through. it is the stuff of therapy.
what should a structured exercise not be used for
emotional space filler (When the group is too loose), nor to make for affect (to energize the group into movement),
what should we do should a group lack energy instead of a structured exercise
explore what is getting in the way of the energy. why stuck?
what kind of group responds well to structured exercise
brief. not long.
when should a therapist review the process notes
directly before a session.
