A dynamic/expressive approach to brief inpatient group psychotherapy

Therapeutic action occurs in groups when patients simultaneously become more accepting of their own thoughts and feelings and increase their capacity to share more benign and mature interpersonal relationships with the therapist and other patients. This orientation can guide practitioners of brief inpatient group psychotherapy in choosing when to use interpersonal, problemsolving, or object relations techniques, or more traditional dynamic/expressive techniques. While the brief inpatient modality requires an increase in suppressive techniques compared to the longterm outpatient modality, suppression must be used judiciously, to facilitate rather than interfere with selfunderstanding and development of therapeutic relationships. Specific technical choices are derived from this principle and illustrated with a case example.     

Integrated group psychotherapy for the treatment of depression in the elderly

Depressive disorders in the elderly are common, and demonstrate a high prevalence, morbidity and chronicity. Psychosocial interventions, notably group psychotherapy can play an important role in the acute and maintenance phases of treatment. Synthesis of the contributions made by developmental, psychodynamic and cognitive-behavioral group approaches, into an integrated model of group therapy, reflects an ever-increasing trend in the psychotherapy field towards the development of applicable and effective clinical interventions. In this model, the overarching principle is the implementation of a group therapy intervention that addresses the objectives of stabilization and restoration of the individual’s sense of self, increased interpersonal competence and acquisition of cognitive and behavioral skills to aid in coping with depression and demoralization.     

The group as selfobject: brief psychotherapy with women

This article applies the theory of self psychology, which was developed by Heinz Kohut, to brief group psychotherapy. The article discusses the significance of the group as an expanded selfobject for individuals who do not have appropriate, available selfobjects in their environment. The article addresses the rationale for developing a 12-week women's group from a self-psychological perspective and illustrates key theoretical concepts in the beginning, middle, and end phases with group process. The role of the therapist in each phase of group development is emphasized.     

A time-limited dynamic approach to adolescent inpatient group psychotherapy

In response to sharply curtailed lengths of stay of adolescents in an inpatient psychiatric program, new therapeutic modalities need to be implemented. A time-limited dynamic approach to adolescent inpatient group psychotherapy is presented. The model integrates psychoanalytic and crisis theory into a group format. The primary focus in this model is upon resolution of problematic interpersonal interactions as they are related to the current crisis state. The group process, as related to the adolescent, involves three phases. These include an initial intake phase, which incorporates an ego-functioning assessment; a second or middle phase which focuses on making actions ego-alien; and the termination phase, which incorporates the learning experience and how it relates to the resolution of precipitators of the admission.     

Two models of brief group psychotherapy for herpes sufferers

The psychological consequences that often follow from contracting genital herpes fall into four general categories: sexual functioning, interpersonal relations, emotional life, and self-esteem. After detailing these, a rationale for treating genital herpes sufferers in group is offered, and then two models for the time-limited group treatment of this population are described. The first is a cognitive behavioral stress management program which has three component parts: relaxation training, rational-emotive training, and assertiveness training. The second is a dynamically oriented group in which the group focus shifts over time from the difficulties associated with the disease itself to general exploration of interpersonal styles and themes. Some comparisons between the two models are drawn.     

Effect of depression on processing interactions in group psychotherapy

Two studies were conducted to investigate the possibility of individual differences in the ability of inpatients to process interactions in group psychotherapy. The first was a pilot study conducted on groups of major depressive patients and matched normal subjects. Subjects were asked to give process comments after viewing simulations of typical group therapy interactions. These comments were later rated on the extent to which they reflected process qualities and accuracy. These data led to a more rigorous and extensive study that included more appropriate control groups as well as measures of potential confounding factors, such as simulation realism, verbal ability, and interaction comprehension. Results indicated that major depressives suffer from deficits in the ability to process group interactions, relative to three types of control groups, including normals. These differences in processing were not significantly positively correlated with any of the potential confounding factors. The implications for understanding interactional processing and group psychotherapy are discussed.     

Outcomes of inpatient group psychotherapy associated with dispositional and situational affiliativeness

Before and after participating in an intensive three-week program of group psychotherapy, 33 recently rehospitalized male veterans (mean age=42) completed the Symptom Check List-90R and the Profile of Mood States. Prior to this program they also completed a trait affiliativeness measure and later rated their subsequent group therapy sessions for situational affiliativeness. The outcome measures indicated medium to large effect size benefits, which consistently associated positively with both separate and joint measures of trait and situational affiliativeness. The results encourage greater clinical attention to affiliativeness, a construct central to interpersonal theories of personality.This article is based upon a dissertation submitted to the Department of Psychology, Michigan State University, in partial fulfillment of the requirements for the Ph.D. by the senior author.The authors express appreciation for the interest and cooperation of Drs. Bruce Vreeland, Larry Schwartz, Robert Munley, and Hope Conte and the patients of the Veterans Administration Medical Center, Battle Creek, Michigan.     

Alcoholics in inpatient,short-term interactional group psychotherapy: an outcome study

The differential outcome of 100 psychiatric inpatients distinguished by the presence/absence of secondary alcoholism was examined in shortterm closed group psychotherapy. Alcoholics did not differ from the general sample in outcome, but displayed distinct active/aggressive personality features. Group outcome was not affected by the presence/absence of alcoholic members.     

The use of brief focal psychotherapy in the treatment of chronic pain

Material is presented from brief focal psychotherapy used in the treatment of four patients with chronic pain refractory to multiple forms of treatment. The value from therapy for each patient is described in terms of actual pain relief, in improvement in understanding the interpretation of past trauma into present bodily symptoms, and in subsequent ability to cope with the pain. Three reported treatment to have improved their pain; one reported an improvement in her ability to cope with it and consequent improvement in lifestyle. The place of pathological mourning in the aetiology of such pain is considered, together with a discussion on the constant finding of denial or displacement of intense anger towards important past figures and its manifestation in the transference. A discussion of the place of brief focal psychotherapy as a time- and cost-effective intervention in the treatment of chronic pain is presented.     

The development and content of an interpersonal psychotherapy group for postnatal depression

Postnatal depression (PND) usually causes distressing symptoms for sufferers and significant impairments in relationships. Group Interpersonal Psychotherapy (IPT-G) provides the experienced therapist with a brief, focused, and manualized approach to helping women recover from the debilitating effects of PND. This paper describes the background and development of IPT-G for PND. The evidence for the effectiveness of individual and group IPT formats with this population is summarized. The triad of theories underpinning IPT are discussed with an emphasis on the important role of attachment styles during the transition to parenthood. Its strengths, which include its unique package of targets, tactics, and techniques, are highlighted. The benefits and challenges of IPT-G are also explored, and the results of a randomized controlled trial are summarized. Finally, a case study illustrates how IPT-G specifically addresses the social role transitions, conflicts, losses, and social isolation that mothers commonly experience.