Primitive group process and therapist technique: An approach to short-term inpatient group therapy

In this paper seven formations of primitive group life are portrayed: the cocoon group and two pathological subformations within it — the fusion phenomenon and the isolation phenomenon; the symbiotic group; the emerging identities group; the common griping group; and the give- and- take group. Three broad categories of technical intervention are outlined for treating primitive groups depending upon which formation is occurring: enhancement of group safety; advancement of identity formation; and encouragement of discussion. The thesis of this paper is that therapists can work more comfortably and successfully in primitive groups with an awareness of primitive group life and with the use of therapist responses that address themselves to primitive levels of experience.     

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.     

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.     

Recognition memory and awareness: An experiential approach

Abstract

This article reviews recent studies that have adopted an experiential approach to recognition memory and awareness. This approach measures two subjective states of awareness in recognition memory, remembering (or conscious recollection) and knowing (or familiarity). There is now evidence of quite a few experimental dissociations between these two states of awareness. These dissociations impose additional constraints on theories about relations between awareness and memory systems or processes.     

Effects of anger management and goal setting group interventions on state-trait anger and self-efficacy beliefs among high risk adolescents

In this study we evaluated the effects of two psychoeducational groups (anger management and goal setting) on state and trait anger, anger expression, and on self-efficacy beliefs of high risk adolescents enrolled in an alternative high school. Participants (n = 57) were pre- and post-tested using the State Trait Anger Expression Inventory (STAXI) with subscales for (a) state anger, (b) trait anger, and (c) anger expression, and on a measure of self-efficacy related to (a) anger management, (b) goal setting, and (c) group behavior and interpersonal communication. We hypothesized that each treatment would favorably impact the self-efficacy items related to it, that participants in both treatment groups would show gains in self-efficacy for general group behavior and communication skills, and that the anger management treatment would decrease state anger and anger expression. Results of a series of Repeated Measures ANOVAS revealed no group effects or group by time interaction effects. Analysis of Cohen's d effect sizes for the treatment groups in comparison with the control condition indicated only small treatment effects for the goal setting group on the STAXI, and small, negative treatment effects for the anger management group on the STAXI and on state anger. Thus, results failed to support the hypotheses with the current data set. Limitations of this study and implications for future research and group practice within schools are discussed. The authors thank Ellen Hawley McWhirter, Greg Sandstrom, and the administration, faculty, and students of the participating “alternative high school” for their help and support.     

Effects of anger management and goal setting group interventions on state-trait anger and self-efficacy beliefs among high risk adolescents

In this study we evaluated the effects of two psychoeducational groups (anger management and goal setting) on state and trait anger, anger expression, and on self-efficacy beliefs of high risk adolescents enrolled in an alternative high school. Participants (n = 57) were pre- and post-tested using the State Trait Anger Expression Inventory (STAXI) with subscales for (a) state anger, (b) trait anger, and (c) anger expression, and on a measure of self-efficacy related to (a) anger management, (b) goal setting, and (c) group behavior and interpersonal communication. We hypothesized that each treatment would favorably impact the self-efficacy items related to it, that participants in both treatment groups would show gains in self-efficacy for general group behavior and communication skills, and that the anger management treatment would decrease state anger and anger expression. Results of a series of Repeated Measures ANOVAS revealed no group effects or group by time interaction effects. Analysis of Cohen's d effect sizes for the treatment groups in comparison with the control condition indicated only small treatment effects for the goal setting group on the STAXI, and small, negative treatment effects for the anger management group on the STAXI and on state anger. Thus, results failed to support the hypotheses with the current data set. Limitations of this study and implications for future research and group practice within schools are discussed. The authors thank Ellen Hawley McWhirter, Greg Sandstrom, and the administration, faculty, and students of the participating “alternative high school” for their help and support.     

Hub Group: an innovative approach to group therapy in a short-term inpatient adolescent unit

Two and one-half years of Hub Group have shown that short-term, ward-based, heterogeneously mixed adolescent groups can work. Backed by a behaviorally based privilege system, Hub Group contracting methods facilitate rapid investment in group therapy, are flexible enough to accommodate change, and provide a meaningful ritual that involves all group members in promoting change for the individual. Hub Group's method of self-rating and rewards promotes objectivity in self-evaluation. The contracts' images are compact, but all encompassing, providing a continuum along which to move in developing greater responsibility and productive functioning for the adolescents. There are distinct advantages and disadvantages to mixed levels of functioning within the same group. The nurturance and tolerance for others fostered by Hub Group is a primary advantage. Despite the obvious disadvantages of rapid turnover, common issues such as acceptance, attachment, and separation are ever present to be addressed. Leadership must be either supportive or confrontive, but always active in these groups. Hub Groups have shown that with the support and supervision of IDTU's administrative staff, diversely trained staff can comfortably perform multiple roles within the unit and be effective as group leaders.     

The relation between anxiety disorder and experiential avoidance in inpatient adolescents

The current study aimed to examine the relation between experiential avoidance and anxiety disorders, as well as the usefulness of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) in detecting anxiety disorder in a sample of adolescent inpatients. First, the relation between experiential avoidance and anxiety among inpatient adolescents was investigated from categorical and dimensional points of view, making use of self-report and parent report, as well as clinical interview, while controlling for depression and externalizing problems. Second, we sought to establish the clinical utility value of the AFQ-Y by determining the sensitivity, specificity, and clinical cutoff score of this measure in predicting anxiety disorder. To this end, a sample of inpatient adolescents (N = 111) with a mean age of 16.14 (SD = 1.39) years completed the AFQ-Y, alongside interview- and questionnaire-based measures of psychopathology. Results showed a significant relation between anxiety disorder and experiential avoidance, independent of depression. Receiver operating characteristics analysis revealed that the AFQ-Y has moderate accuracy (area under the curve = .815, SE = .047, p < .001) in discriminating adolescents with a diagnosis of any anxiety disorder (cutoff score 26.5; sensitivity = .74, specificity = .76). Given the comorbidity of anxiety and depression in this sample, this cutoff is not indicative of pure anxiety disorder but may be helpful in predicting those with emotional disorders in general.     

An open-learning approach to career management and guidance

Assumptions about the nature of career development are changing in the face of organisational and technical change in the workplace. Individuals are now less likely to experience secure, lifelong employment, and instead will need to face the process of career review and change with greater frequency. They will therefore need to be skilled in managing their careers effectively. Open-learning approaches to career management and guidance have until recently been comparatively little used and yet they offer the potential for action-oriented career planning, provide a career decision framework for learners, and encourage increased ownership of the career management process by the individual taking part. They can be used in educational and commercial settings to facilitate both the processes of initial career choice and those of career development and progression. From the perspective of the careers practitioner, they offer a high-volume, but not necessarily low-cost, approach to the delivery of career programmes. Evaluation evidence is reviewed from two programmes developed at the Open University and the University of Sussex respectively. The range of learning outcomes they deliver is discussed     

Cotherapy in psychodynamic group psychotherapy: An approach to training

Cotherapy in a training relationship with a senior therapist/supervisor and a trainee/junior leader is presented. A structured training year with planned sessions for the junior leader to lead the group alone, as well as intensive supervision, is described. The training relationship is seen as evolving into an egalitarian, collegial working relationship. An incidental benefit of this cotherapy approach is that additional opportunities are provided for group members to work through attitudes, feelings, and behaviors associated with attachment, interpersonal relationship (autonomy and affiliation), separation, and loss. Potential drawbacks and applications are also noted.The authors express their appreciation to the many group members and cotherapists whose experiences provided the stimulation and clinical material for the present formulation.     

What student psychotherapists want from an experiential group

A study of four thirty-week experiential groups, involving two group conductors and forty-one other group members showed that 90 per cent of students' expectations of change were exceeded, indicating increase in interpersonal learning and, over a longer period, emotional change. the culture of the groups was consistently positive and expressive. There was some evidence that conductors had a similar style which corresponded to that predicted by the group analytic method, and that both showed behaviours which were indicators of ‘good quality' therapy. There were substantial correlations between a positive culture and better than expectation outcome at the end of term one, and good psychodynamic practice by the conductors and outcome at the end of the course.