Book reviews and books received

A passport to clients everywhere Paul Pederson (ed.):Handbook of Cross-Cultural Counseling and Therapy. Westport, Connecticut: Greenwood Press, 1986, £18.50.

Key cases in psychotherapy:their effect on therapists Windy Dryden (ed.): Key Cases in Psychotherapy. London: Croom Helm, 1987. 12822.50. Reviewed by P. Paul Heppner and Mary J. Heppner, University of Missouri-Columbia, USA

An integrative approach to identity, threat and coping Glynis Breakwell:Coping with Threatened Identities. London: Methuen, 1986. f7.95. Reviewed by Dr Petriaka Clarkson, metanoia Psychotherapy Training Institute, London.

An open look at Open University workshops The Coping With Crisis Research Group:Running Workshops: London: Croom Helm, 1987. f12.95. Reviewed by Maria Gilbert, metanoia Psychotherapy Training Institute, London.     

Psychic development and the group analytic situation

Psychic development can be viewed as the emergence and establishment of coherency which is an aspect of organization. This paper discusses the concept of coherency and reviews some early developmental processes in the mother/infant interaction that establish coherency. The development of the matrix of the analytic group is viewed as the establishment and development of group coherency. Finally, the link between the development of individual coherency and group coherency is outlined.Dr. Malcolm Pines is a Consultant Psychotherapist at Tavistock Clinic, founder member of the Institute of Group Analysis (London), member of the British Psychoanalytical Society, and Past President of the International Association of Group Psychotherapy.     

Some thoughts on the existential lens in group psychotherapy

Existential psychotherapy provides a useful perspective, or lens through which to view the practice of group psychotherapy. The field encompasses a variety of theoretical and practical points of view, many not usually thought of as existential. Some relate to the therapist, some to the enterprise of psychotherapy, and some to conceptions of psychic or external reality. This paper identifies several of these vertices, emphasizing especially (1) the importance of relationship in psychotherapy, (2) the problem of meaning (3) addressing existential concerns, especially the centrality of death as a problem in living, and (4) the task of the therapist. Attention is paid to the historical development of these ideas. The work of Martin Buber, Otto Rank, Wilfred Bion, and Viktor Frankl is especially emphasized, although proto-existential concepts from other waters are also noted. The heart of the paper deals with the application of these vertices to group psychotherapy. Extensive attention will be given to the differing viewpoints of Hugh Mullan and Irvin Yalom. Practical applications in group psychotherapy, including clinical vignettes, are offered.This paper was originally delivered, in somewhat different form, at the National Group Psychotherapy Institute of the Washington School of Psychiatry on April 23, 1995. It was dedicated to Hugh Mullan, who had been one of my teachers at the school two decades earlier.     

The impact of race and ethnicity on transference and countertransference in combined individual/group therapy

Interracial group psychotherapy is workable. Psychodynamics get cathected onto race; as this paper will show, the group process elicits feelings about racial and ethnic differences with greater intensity than in individual therapy. Analysis of race/ethnicity can be both problematic and growth enhancing for treatment. The process of identifying conscious and unconscious feelings and thoughts of race/ ethnicity can stimulate major resistance, which can engender difficulties in maintenance of a working alliance. However, the working through of these feelings/thoughts may have a catalytic effect and lead to a more rapid unfolding of core psychodynamic issues. Case material from a multi-racial/multi-ethnic therapy group illustrate these issues.The author wants to thank Drs. Nina Fieldsteel, Bob Addison, and Judith Caligor for their support and critical commentary, and Helene Kylen for her editorial assistance. An earlier version of this paper was presented in 1986 at Culture, Race, and Ethnicity in Group and Family Therapy, sponsored by Eastern Group Psychotherapy Society, New York University, and the University of Puerto Rico.     

Acceleration of the therapeutic process with group

This paper deals with the impact of adding group to individual treatment of patients with neurotic character problems and attempts to illustrate the efficacy of this dual approach. The formidable task for the individual therapist is to make these patients see that their habitual ways of reacting are pathological and stem from repressed intrapsychic conflicts. This task is facilitated in a group in a number of ways since the group setting becomes an arena that affords wider therapeutic scrutiny. Having become aware that behavioral characteristics disguise anxiety, other group members initiate independent efforts to extract the underlying meanings for their fellow members. Their interventions are often more effective and acceptable because they are less likely than the therapist to be perceived in the projected image of the bad parent.Copyright, 1980, Washington Square Institute for Psychotherapy and Mental Health, which published this paper in No. 7 of the Group Psychotherapy Monograph Series, after the paper had been presented at the Seventh Annual Conference of the Group Psychotherapy Department.     

A Brief History of Jungian Splits in the United Kingdom

The institutionalizing of analytical psychology in the United Kingdom has its origins in the Analytical Psychology Club founded on 15 September 1922. It became increasingly apparent that professionalization of the Jungian movement was essential and this led to the formation of the Society of Analytical Psychology in 1946. This was followed in 1951 by the founding of the British Association of Psychotherapists. The Association of Jungian Analysts split off from the Society of Analytical Psychology in 1975–6, and this was followed in 1982 by the split between the Association of Jungian Analysts and the Independent Group of Analytical Psychologists. The Berlin Congress of 1986 saw the beginnings of a liaison body for the four London societies, which came to be called the Umbrella Group. This has organized joint conferences and workshops, but the split in 1992 between the United Kingdom Council for Psychotherapy and the British Confederation of Psychotherapists has posed a new threat to the growing harmony between the London societies. In the face of this threat, the Umbrella Group has not been able to articulate a common policy and strategy about the Jungian presence in the United Kingdom.     

Signals of transcendence in large groups as systems

Large groups are social systems of approximately 30 plus persons. Such groups offer unrivalled opportunities to study the dynamics of large institutions, particularly if the meaning of participation is expanded to include the capacity for reverie and to hearken to come to know the group in an hermeneutic-spiritual way. It is this mental disposition that allows for new dimensions of large group life to be brought into being. There are, however, larger preoccupations available for exploration. There is the imago of the cosmos that is held in the minds of participants; the potential experiences of transcendence and immanence. There is also the nature of the relatedness and separatedness between Self and Other. This paper focuses on the evidence for the experience of transcendence (signals or fragments of transcendence), which is possible if the individual is neither lost in the Self or the Other.Previously he was a Social Scientist at the Tavistock Institute of Human Relations, London, and from 1976 to 1982 was joint-director of its Group Relations Training Programme. His career has been in the army, industrial banking, education, and business. Address correspondence to: 10, Meadway Court, Meadway, London NW11 6PN, Great Britain.     

Psychotherapy in Saudi Arabia: Its History and Cultural Context

The introduction of modern mental healthcare standards and services in the Kingdom of Saudi Arabia (KSA), has resulted in a gradual shift towards a more positive perspective on mental health issues and related services, and has increased the demand for qualified mental health professionals and psychological interventions (WHO 2016). Despite recent advances in mental healthcare services, psychopharmacology remains the main treatment modality for the majority of mental health issues in KSA. Psychotherapy has had a rather slow developmental trajectory in KSA, and its provision requires an understanding of many specific aspects of Saudi culture (Dubovsky 1983). This paper will shed light on the historical development and current challenges of psychiatric and psychological services and the availability of psychotherapy in KSA. By offering an explication of a selection of local social phenomena, this paper will attempt to explain how unique Saudi cultural constructs and social contexts influence the training, perception, and practice of psychotherapy in the country, outlining existing challenges as well as some expected future directions.     

Contemporary Psychotherapy: Moving Beyond a Therapeutic Dialogue

Psychotherapy was developed as a means of using words to heal emotional pain. Although a therapeutic dialogue can be helpful to many clients, some people need a more action-based intervention. Psychotherapy may be enhanced by adapting several therapeutic procedures that have been found effective in physical therapy. Where physical therapy can help clients learn to manage chronic physical pain, psychotherapy can help clients learn to manage chronic emotional pain. Both physical therapy and psychotherapy can help to facilitate awareness, flexibility, strength and endurance in order to maximize the clients functional ability.     

A fertile matrix: the birth of the Forensic Psychotherapy Society

This paper traces some aspects of the fertile matrix within which, over many years, the application of a psychoanalytic perspective to clinical work with the most severely mentally ill, difficult and at times frightening patients in secure and community settings has evolved and now led to the recent inauguration of the Forensic Psychotherapy Society (FPS), a new Member Institution of the British Psychoanalytic Council. The Society provides both a framework for a national, multidisciplinary professional training in psychodynamic forensic psychotherapy and the potential launching pad for an active post-qualification organisation supporting CPD and all other forms of professional development. The particular contributions to the birth of the FPS of the Forensic Psychotherapy Department at West London Mental Health NHS Trust, partly because we know it best but also because it is part of the largest forensic psychiatric service in the United Kingdom, are described.     

Significant events in a psychodynamic psychotherapy group for eating disorders

This qualitative pilot study was designed to identify and explain significant events for patients participating in a psychodynamic psychotherapy group for eating disorders. Specifically, seven members of a mixed (i.e., anorectic, bulimic, obese) eating disorders group recorded what they perceived as the three most significant events in group meetings for 14 weeks. In addition, group members were instructed to record why each event was significant. Manifest and latent content analyses of the data revealed that members found feedback and observing others the two most common types of significant events, and emotional experience, insight, and relationship the reasons these events had such impact. The implications of these results for working with the eating-disordered patient in group, as well as their implication for general group theory and practice, are discussed.An earlier vesion of this paper was presented at the 1991 meeting of the American Group Psychotherapy Association, New York. This paper was funded, in part, by a California State Faculty Support Grant and a Santa Barbara Cottage Hospital Research Grant awarded to the first author. The authors would like to thank Sean T. Casey, Sally Barton, Dr. Allison Wollitzer, Tom Knowlton, Craig Park, and Beth Buxton for their assistance in the preparation and execution of this study.     

Group psychotherapy with alcoholics: Interface with self-help groups

This paper addresses recovering alcoholics' concurrent involvement in psychotherapy groups and self-help groups. A developmental model of alcoholism group psychotherapy is presented, differentiating between early and advanced sobriety. Psychotherapy and self-help groups are compared and contrasted. Multiple group membership entails various areas of compatibility. Divergence and conflict result from differences in underlying conceptual framework and approach. Clinical implications of members' involvement in partially discrepant group settings are explored with an emphasis on transference and countertransference reactions. Multiple group membership is identified as a salient factor in alcoholism group psychotherapy at all levels of recovery.She is also in private practice.This paper was presented at the American Group Psychotherapy Association Annual Conference, Boston, February 1990.     

Systems-centered training groups' process and outcome: a comparison with AGPA institute groups

In this quasi-experimental study we compared the process and outcome of six experiential Systems-Centered Training (SCT) groups to those of American Group Psychotherapy Association (AGPA) Institute groups from two prior studies (MacKenzie, Dies, Coche, Rutan, & Stone, 1987; Tschuschke & Greene, 2002). The SCT training compared well overall and the results provided preliminary, indirect support for the usefulness of "functional subgrouping" - SCT's conceptual and methodological bridge between the group-as-a-whole and the individual member. However, quasi-experimental design limitations make other interpretations equally plausible. Within-group change in the process variables for the SCT groups was also explored, as well as the relative contributions of these variables to post-training learning outcomes and anxious and depressive experience. The results partly corroborated prior studies, but also suggested that SCT may alter training group dynamics, learning, and emotional experience in ways consistent with SCT theory.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Keeping a group psychotherapy program alive and well within a psychiatric residency

A mandatory year of outpatient group therapy training is an accepted part of residency training in psychiatry. Residents need stable groups to lead in order to have a satisfactory training experience. A solid group program is integrated and cohesive. A group therapy coordinator has to consider the following factors in developing and maintaining the optimum program: sanction from the department of psychiatry; integration of the program into the system; transfer of groups from one class to another; personal screening and followup of all referrals; availability to professionals in the community; coordinator participation in relevant group therapy classes; a vehicle for supervisors to collaborate with each other and administrator; and a format for all members of the group program community to interact.This paper is an elaboration of a symposium presentation, Training in Group Psychotherapy: The Quest for a Viable Model, AGPA Annual meeting, 1990.     

Sexual abuse as a theme in group-analytic therapy

The group-analytic approach, which emphasises the individual in a network of group relationships, is described with reference to the subject of sexual abuse in childhood. Three different National Health Service psychotherapy groups run by the author provide contrasting examples of how the theme, originating in an individual participant, was manifested in the dynamics of the group-as-a-whole. The therapeutic significance to the individual and the group is explored.     

The capacity to join in the group process

This paper explores the difficulties certain individuals have in joining the interactional processes that make a group work. It explores the sequelea of traumatic early failures in need mediation, notably the encapsulation that renders them unresponsive to efforts by fellow group members to engage them. An uncanny similarity to holocaust victims is observed. Illustrative case examples are cited and suggestions for treatment offered.This paper was part of a symposium entitled Love and Hate in Group Therapy presented at The 11th International Congress of Group Psychotherapy, Montréal, Quebec, Canada, August 1992.     

A Way to the Soul of the Mentally ill by Gertrude Schwing

Abstract

Despite the skepticism and indifference to group psychotherapy that existed in the 1950s and 1960s within the psychoanalytic community in general and among the staff and administration of the Menninger Clinic in Topeka, Kansas in particular, a few clinicians there forged ahead in pursuit of incorporating this modality as an accepted treatment. After gaining some acceptance first in the hospital, we experienced a slow rate of growth, except with our trainees who were generally enthusiastic about group work. Many of them were intrigued first by their exposure to the group dynamics seminars and later by the didactic courses and supervised group work that eventually came to be required by the accrediting body for residency programs of the American Psychiatric Association. Visiting senior consultants and teachers, mainly associated with the American Group Psychotherapy Association, as well as an esteemed clinician from the Tavistock Clinic, also lent credibility and legitimacy to our effort. When group treatment began to be adopted by units of the Menninger Hospital in the early 1970s, there was a significant sea change in the attitude of the organization and group psychotherapy became a well established modality.     

Does Every Good Behaviorist Deserve Favor? A Reply to Neil Jacobson

This is a response to Dr. NeilJacobson's article, An Outsider's Perspective on Psychotherapy Integration, which appears in this issue. It addresses the issue of the differences between eclecticism and psychotherapy integration as well as the possible advantages integration holds over a one-model therapy system. This article suggests that virtually all psychotherapy systems operate under an integrated three paradigm model, and offers some concrete examples of this explanation. It also suggests that the use of psychotherapy integration may lead to a better paradigm match between client and therapist, and ultimately to better outcome. This article concludes that psychotherapy integration possibly offers the best alternative in terms of reducing the biases of one's underlying treatment oaradiem.     

Editor's Introduction

This editorial introduces a series of articles by leading proponents of the ten major models of group psychotherapy to appear in the International Journal of Group Psychotherapy. These theoretical contributions will be published throughout 1992 as a dedication to the American Group Psychotherapy Association's (AGPA) 50th anniversary. In the present article, the author reports results from a recent survey of senior clinicians within AGPA who expressed their opinions about the central issues that practitioners should understand during the working phase of group treatments. Statistical comparisons among action-oriented, interpersonal, and psychodynamic respondents to the questionnaire revealed striking differences in how therapeutic interventions were conceptualized. These findings are outlined as a preface to the first three articles in the series.