Cultural Psychotherapy: A Consideration of Psychosocial Class and Cultural Differences in Group Treatment

Most psychotherapists are aware of the many social issues and cultural factors that influence development throughout each individual life. Human nature, being a social nature, exists within relationships to others, the community, and a culture, sometimes a mixture of cultures. One social parameter, social class, redefined here as psychosocial class, has not received the same attention from psychotherapists as gender issues or ethnicity, two other important sociocultural spheres of influence on everyday life. It is suggested that group therapists are in a unique position to develop a cultural psychotherapy that addresses psychosocial class and cultural aspects of mental health. This paper includes a preliminary model of cultural psychotherapy that highlights the psychology of social class and culture for psychodynamic group psychotherapy.     

团体心理治疗中凝聚力的概念及测量研究述评

团体心理治疗中的凝聚力最初多被定义为人际信任、吸引和卷入,随着研究的深入,凝聚力的概念逐渐向多维的方向发展。对凝聚力的测量主要有MacKenzie的团体氛围量表、Lese等的治疗因素-凝聚力分量表及Piper的凝聚力量表等。目前团体心理治疗领域的研究对凝聚力的认识缺乏一致性。从凝聚力的概念建构着手,探索团体心理治疗过程,开发评估工具,构建系统的理论和模型,是值得国内研究者关注的方向。     

Anticipatory Anxiety in the Treatment of Combat Veterans with Posttraumatic Stress Disorder

Combat veterans have experienced a transformational process during war zone deployment, including emotional, cognitive, and sensory processing changes. They also return entrenched in military expectations of conduct and behavior. These changes result in anticipatory anxiety that makes it difficult to reintegrate into the civilian world, and are related to symptoms of posttraumatic stress disorder (PTSD). The PTSD Recovery Program at the McGuire Veterans Affairs Medical Center (VAMC) is a manualized treatment that focuses on the personal and daily experiences of combat veterans rather than exposure to traumatic memories. Program evaluation data demonstrated significant reduction in PTSD symptoms and improvements in general self-efficacy and adaptive behaviors. Results support the PTSD Recovery Program as an effective treatment that enhances readjustment to civilian life.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

Group Treatment of Sexually Abused Adolescent Girls: A Review of Outcome Studies

Abstract

This paper considers factors that make children “at risk” for postdivorce maladjustment. The risk factors include (a) demographic variables of sex, age and socioeconomic status; (b) predivorce family functioning; (c) postdivorce relationship with the ex-spouse; (d) postdivorce parentchild interaction; and (e) social support systems. Treatment programs incorporating these factors are briefly described. Recommendations are provided for the clinician and researcher.     

Hatred in Group Therapy: A Rewarding Challenge

Hatred is a powerful affective experience that can be disruptive to the work of a therapy group, yet it may also enhance a member's capacity to deal with strong affects. This paper explores a particular aspect of hatred, the hate directed at one member of a cotherapy team. An effort is made to explore the experience from an intersubjective and motivational systems perspective, focusing primarily on the therapist and one patient. The impact of the cotherapy relationship is also considered, as well as the whole group's capacity to contain and work with this powerful affective response. The way that the group managed this explosive situation speaks to the power of group therapy in healing and transforming its members.     

Raising Fees in Group Therapy: Some Ethical and Clinical Implications

Of all money matters in group psychotherapy, one of the most neglected in the literature is the issue of raising the fees. The premise of this paper is that there are ethical and clinical considerations to group fee increases. One consequence of the lack of attention to the subject of raising of fees is that many neophyte group leaders do not learn about its complexity. It will be argued that the raising of fees is not merely a straightforward matter of informing groups about an impending change in the amount of money that they will pay but rather, it is a knotty, emotionally charged issue with both realistic and subjective components for members and leaders alike. Further, it will be argued that the issue of raising fees in group therapy is dissimilar, in significant ways, from raising fees in individual treatment. When leaders use subjective criterion to decide an increase, then the group process may be disrupted. Suggestions for reform will be offered.     

Difficult Terminations in Group Therapy: A Self Psychologically Informed Perspective

In group therapy, terminations that are neither planned nor anticipated are sometimes referred to as difficult. This complex issue of difficult terminations is used as a vehicle to challenge the prevailing, though often unspoken, assumption that the goal of the group therapist is to keep the members in the group. The author presents the notion that the leader needs to maintain a balance between the group as a treatment context, and the goal of that context. The goal of group-as-treatment context is to provide for the therapeutic needs of each individual patient in the group. Self psychology provides a basis for redefining the therapy group as a treatment context. A specific rationale, goal, and process of that redefinition is presented along with illustrative case material. With this understanding, unanticipated terminations can be as readily accepted and understood as ones that are planned. All terminations are viewed as further opportunities to understand how a patient defines his or her sense of self, sense of other, and sense of self with other.     

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.     

Phases of Group Development: A View from Self Psychology

This paper delineates four phases of group development from the standpoint of self psychological theory. The author contends that a stable sense of groupself develops over time and that the groupself has a distinct number of phases, each of which has a therapeutic impact on members. The individual patient's selfobject experiences include a relationship to the group-as-a-whole, a transference state of which the leader is but one part. Thus, rather than dilute the transference, group analysis offers a unique opportunity to help the individual experience him or herself within a selfobject matrix that extends beyond the dyad. Group analysis leads to a strengthening of the self, especially as it enables the self to experience itself as part of a group identity, which provides alter-ego selfobject experiences, as well as a sense of acceptance within a larger community. This paper attempts to clarify how different selfobject experiences may be highlighted within the groupself at different stages of group development.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Group Psychotherapy in the Context of Cultural Diversity

The authors review the salient issues involved in therapy with culturally diverse populations. They present a framework where group therapy addresses those issues. Clinical vignettes from each of the authors serve to illustrate the power of group therapy with ethnocultural populations.     

Multiculturalism and Group Therapy in the United States: A Social Constructionist Perspective

Multiculturalism encourages the inclusion of the broad range of cultural differences that exist in society into our therapeutic dialogues. This paper examines multicultural group therapy through the perspective of social constructionism. Emphasis is given to the unacknowledged and unspoken imbalance of power that exists in psychotherapeutic contexts. The concepts of multiple individual identity and cultural representation are discussed and illustrated with case examples. Clinical considerations for the multicultural group therapist are provided.     

反社会型人格障碍的心理治疗

该文从认知一行为治疗、个别治疗和团体治疗等方面,介绍了反社会型人格障碍心理治疗的研究进展情况,旨在促进国内有关反社会型人格障碍心理治疗的研究。     

Group Therapy with Individuals and Families Coping with Illness or Disability in Israel

This paper illustrates a group intervention with individuals and family caregivers coping with illness/disability, and focuses on the relationship between the process of group development and the process of coping with the illness/disability. People experiencing illness/disability cope with a great deal of pressure and stress that stem from the illness's biopsychosocial demands. A group can provide encouragement and support and reduce helplessness, isolation, and despair through cooperation and use of mutual resources. The design of the intervention was based on our clinical experience with numerous groups for ill/disabled individuals or their family. The process is described and analyzed using examples from three documented groups, and is presented in terms of four variables: group process, group atmosphere, group content, and group intervention.     

Combined Group and Individual Psychoanalysis: An Antidote to Ferenczi's Identification with the Aggressor

Ferenczi's recommendations that analysts not only listen to their patient's criticisms but encourage them to be so bold as to speak up when they disagree is facilitated in a combined group and individual psychoanalysis. Because group analysis occurs in the presence of others and with the participation of others, it acts as a protection against an identification with the aggressor that can occur when the therapeutic dyad is isolated from outside influence. Case examples from a combined psychoanalysis as well as a combined supervision are given to demonstrate these points.     

Beyond Emotional Intelligence at Work:: Adding Insight to Injury Through Group Psychotherapy

The author applies the popular concept of Emotional Intelligence (EQ) to the group treatment of work problems. Adding psychodynamic insight to the existing EQ dimension of understanding emotions and utilizing emotional awareness, helps patients improve their reactions to problematic situations and individuals. By focusing on discordant episodes that arise in group, the author employs a systematic approach to identifying unconscious contributors to diminished job performance. Methods for assessing deficits in EQ and for processing relevant group discords are described. Clinical illustrations are provided.