Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Analytic Group Psychotherapy with Children,Adolescents and Adults by S. R. Slavson

Abstract

A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit’s treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three–stage group designed to help patients achieve these goals.     

Group Counseling and Group Psychotherapy with Rehabilitation Clients

An instrument designed to measure components of two distinct alcoholism aftercare treatments was developed and evaluated for reliability and validity. Trained judges reliably rated audiotaped samples of coping skills and interactional group therapy sessions. Coping skills groups engaged in significantly more education and skill training, problem solving, and role playing. Interactional groups showed more interpersonal learning, expression/exploration of feelings, and here-and-now focus. Groups that employed more education and skill training, less expression and exploration of feelings, and less her e-and-now focus were associated with fewer members reporting subsequent drinking-related problems. None of the ratings of group activities was related to abstinence.     

Adolescent Focused Psychotherapy for Adolescents with Anorexia Nervosa

The paper describes a manualized specific form on individually based developmentally oriented therapy for Anorexia Nervosa (AN) in adolescents. Adolescent focused psychotherapy for AN is derived from a self-psychology model and is designed to address key deficits in development associated with AN. Adolescents with AN are viewed as using food and weight to avoid negative affective states associated with adolescent developmental issues that they perceive as intolerable. To develop a more constructive coping style and improve self-efficacy, adolescent patients need to first learn to identify and define their emotions, and later, to tolerate emotions, particularly negative ones. In withdrawing from the environment and situations which provoke distress through self-starvation and preoccupations with food and weight, emotional and psychological development is arrested. Learning to identify and cope adaptively with emotions and developmental challenges presented by the environment form the key therapeutic targets of treatment. Specific therapeutic procedures, a case illustration and discussion of therapeutic rationale are also provided.     

Group Psychotherapy with Latency Age Boys

This study examines the confidentiality practices of highly experienced, well-trained group psychotherapists. A provocative finding was that practitioners rarely inform prospective clients of confidentiality limitations. Their reluctance to do so appears to be based upon the belief that it might discourage persons from entering treatment, as well as having negative ramifications for the therapeutic process (e.g., members may be less likely to talk about unprotected topics). The prevalence and content of breaches in confidentiality are explored. Ethical, legal, clinical, and educational implications of these and other findings are addressed. Research recommendations are offered.     

AIDS Group Psychotherapy

Abstract

Clinical data are presented from a day spent at a New Jersey high school severely impacted by the World Trade Center disaster. Dissociation, a sense of numbness, anger, and guilt about feelings induced by the tragedy are all common dynamics in adolescents responding to trauma. The developmental issues that adolescents are confronting are described and discussed in terms of the challenges they present to the healing process. An argument is made that using groups to aid in the long recovery process with our young people should be a top public health priority.     

Group Assertion Training with Adolescents

The effect of group assertion training was assessed with junior high school boys and girls. Adolescents identifies as unassertive were divided into treatment, placebo, and control groups. The assertion training occurred over a period of two weeks. Compared with placebo and assessment-only groups, the assertion-training group showed increased assertiveness in a role-play situation. The increased assertiveness and generalization of skills were maintained two weeks later.     

Practicum of Group Psychotherapy

Abstract

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples. The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom’s (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self–understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, and comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients’ and psychiatrist’s ratings showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross–cultural psychology.     

Clinical Improvement in Adolescents Comorbid for Substance Abuse and Psychiatric Diagnoses Through Multiple Group Psychotherapy

In a pilot study, the authors examined the outcome of group psychotherapy for the treatment of 19 adolescents, comorbid for substance abuse and psychiatric diagnoses, in terms of symptom reduction. They compared presenting symptomatology of treatment completers with treatment noncompleters. A retrospective study of the outcome of a multiple group psychotherapy treatment program using the Drug Use Screening Inventory-Revised Version (DUSI-R) to assess change over time was conducted. Depressive disorders were the most prevalent psychiatric diagnoses (68%), and marijuana was the substance most commonly abused on a frequent basis. Treatment completers showed improvement in behavior problems, health status, and social competence. As part of an integrated treatment program, multiple group psychotherapy is a promising treatment modality for adolescent patients, comorbid for substance abuse and psychiatric diagnoses, pending further assessment of the complex issues involved in combined treatment.     

Working with Racial Themes in Group Psychotherapy

Racial themes frequently emerge in group psychotherapy but are often unaddressed by therapists. Confusion about the relevance of race to the psychotherapeutic process, countertransferential responses, and a lack of training in how to address racial content contribute to therapists' reluctance. Approaches to addressing racial content in groups are examined. Case examples are used to demonstrate therapist characteristics and perspectives on the group process that create a climate where racial content can be explored. An exploration of the meaning of racial content provides an opportunity for deepened understanding of interpersonal relationships for patients and therapists.     

Transference-Focused Psychotherapy for Borderline Adolescents: A Neurobiologically Informed Psychodynamic Psychotherapy

In this article we first contextualize and then outline a model of TFP adapted for working with adolescents with Borderline Personality Disorders. We discuss how to take the normal developmental challenges of adolescence, such as separation-individuation in consideration, and how to support this in the context of the therapeutic work, while at the same time stimulating curiosity through clarification and confronting the adolescent with self-defeating and destructive patterns and dangerous behavior. Furthermore, we give examples of working with split–off parts of self and other representations through clarification to increase self-awareness and confrontations with contradictions within the adolescents communication and nonverbal behavior, with the aim of facilitating the integration of identity.