CLIN GROUP THERAPY BOOK

• Group therapy


  Practiced in a wide variety of forms, including adaptations of many well-known individual therapy approaches
• Group therapy

  • Strongly emphasizes interpersonal interaction
  • Allows for a far more complex network of relationships to develop compared to individual therapy
• Interpersonal approach to group therapy


  Emphasizes the way group members feel, communicate, and form relationships with one another
• Irvin Yalom


  A leading figure in the interpersonal approach to group therapy
• According to Yalom, all psychological problems stem from flawed interpersonal relationships
• If interpersonal relationship problems are the core of all psychopathology, it follows that a primary focus of group therapy would be the strengthening of interpersonal relationship skills
• Universality


  Clients with psychological problems realizing that others share their struggles
• Group cohesiveness


  Feelings of interconnectedness among group members, characterized by warmth, trust, acceptance, belongingness, and value
• Interpersonal learning


  Learning from the in-group interpersonal experience, where group members use the group as a place to identify and revise problematic relationship tendencies
• Social microcosm


  The group becomes a reflection of the relationship tendencies that characterize clients' relationships with important people in their personal lives
• Here and now


  The group therapist focuses on the way members relate to one another within the context of the group, rather than on events outside the group
• Open-enrollment groups


  Groups that allow individual members to enter or leave the group at any time
• Closed-enrollment groups


  Groups where all members start and finish therapy together, with no new members added during the process
• Characteristics that would cause a group therapist not to select a prospective member include those that would interfere with the client's ability to interact meaningfully with others and reflect on that interaction, such as psychosis, organic brain damage, acute crisis, and pragmatic issues such as travel or transportation that would interfere with regular attendance.
• Preparing clients for group therapy


  1. Assure clients that misconceptions about group therapy are false

  2. Provide realistic and encouraging data about how well their therapy works for most clients

  3. Orient clients to the kinds of activities that will take place in group therapy

  4. Encourage behaviors that can maximize the benefit they receive, such as active participation and consistent, punctual attendance
• Developmental stages of therapy groups


  • Initial stage: Clients are cautious and concerned about whether they will be accepted into the group
  • Second stage: There is some competition or jockeying for position within the social pecking order
  • Third stage: Cohesiveness forms, members feel closely connected and trusting of one another, and the group sessions become more consistently productive as clients learn about and improve on their interpersonal skills
• Advantages of cotherapists

  • A second set of eyes and ears to notice the rich array of verbal and nonverbal communication
  • Ability to model collaborative relationships for group members
  • Recapitulation of the family group for clients who grew up in two-parent homes
• Potential pitfalls of cotherapists

  • Cotherapists don't trust each other, compete with each other, or "step on each other's toes" by approaching group therapy with incompatible therapy orientations
• Clients who socialize with one another outside therapy groups can become more loyal to their friendship than they are to the group as a whole, be reluctant to comment frankly on each other's behavior in front of the group, and save their most direct, meaningful exchanges for private moments rather than sharing them during group sessions.
• The consequences of one client violating the confidentiality of another can seriously affect the professional or personal life of the client whose confidentiality has been violated, and such breaches make the therapy group seem unsafe and untrustworthy, which decreases self-disclosure by other clients.
• Group therapy is superior to no treatment and generally as effective as individual therapy, although a minority of comparative studies have found individual therapy to be slightly superior.
• Cohesiveness within the group, much like the therapeutic relationship in individual therapy, is a major contributor to successful outcome in group therapy.
• Group therapy tends to be a less expensive mode of therapy compared to individual therapy.