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.     

Subgroup differentiation as a response to an overly‐inclusive group: a test of optimal distinctiveness theory

Optimal distinctiveness theory (ODT; Brewer, 1991, 1993a,b) argues that people can respond to membership of an overly inclusive group by engaging in a drive for subgroup distinctiveness. To test this, 280 subgroup members (humanities and maths‐science students) rated the extent to which they perceived their superordinate group (University of Queensland) to be inclusive. After performing a task designed to activate their superordinate category membership, participants completed a questionnaire assessing inter‐subgroup attitudes. Consistent with ODT, ratings of superordinate inclusiveness explained a moderate amount of variance in subgroup bias (5–8 per cent), such that the more inclusive the superordinate category was seen to be, the more bias was demonstrated. The results are discussed in terms of their relevance for ODT and their implications for promoting subgroup harmony. Copyright © 1999 John Wiley & Sons, Ltd.     

Decision performance and diversity structure: Comparing faultlines in convergent,crosscut, and racially homogeneous groups

Group diversity structure (the composition of racial and job-function diversity) and pre-discussion decision effects on group decision accuracy were tested in three-person groups. Evidence supported the social categorization model and the notion of multiple faultlines (i.e., subgroup boundaries). Crosscut diversity structure, where racial and job-function subgroup boundaries are crossed, weakened faultlines, enhanced information sharing and improved decision-making. Our data also supported the common knowledge effect. Groups in which members made pre-discussion choices arrived at incorrect decisions consistent with majority members’ pre-discussion preferences, based on a biased subset of information. Crosscut groups in which members did not make pre-discussion choices performed the best. Analyses of video taped interactions and attitudes toward the group help to explain these differences. We discuss the implications for managing demographically diverse groups and for future research on the impact of various attributes of diversity in groups.     

Overprotective Relationships: A Nonsupportive Side of Social Networks

Chronically ill adults who feel overprotected by family members tend to be more depressed. However, little is known about the source of these feelings of overly protective care. In this study, three explanations why family members may be seen by stroke patients as overprotective were tested: (a) a discrepancy between patients and caregivers in judging patient functioning; (b) caregiver protective behaviors, such as restricting the patient because of fear for the patient's safety; and (c) caregivers' negative attitudes toward the patient. Consistent with prior work, patients who felt overprotected were more depressed even when the severity of the stroke was controlled for. Caregivers with negative attitudes toward the patient were most likely to be seen as overprotective by the stroke patient. Ways in which negative, resentful attitudes of caregivers are translated into behaviors that engender feelings of overprotection are discussed.     

Attitudes towards psychological treatment among older Australians

Reasons behind older adults' under‐utilisation of mental health services are complex. Barriers to access to mental health services for this group include service access and availability, attitudes of medical and mental health professionals, and attitudes of older people themselves. This questionnaire‐based study sought to investigate variables that may influence attitudes towards psychological help seeking among a late mid‐age–young‐old Australian sample of 159 community‐dwelling adults. The results suggest that attitudes towards seeking psychological help in this population were relatively positive. In addition, >50% of participants in the sample indicated that they had sought treatment for emotional or psychological difficulties in the past, with the greatest proportion of those who sought help noting that it was for “family problems” (56%). The findings suggest that negative attitudes to help seeking in this age group may not be as pervasive as previously assumed, and that help‐seeking behaviours may be high among those with positive attitudes towards help seeking.     

The effect of a vocational unit on the exploration of nontraditional career options

As part of a community college orientation course, a curriculum model was developed to help male and female students explore career goals with an awareness of the influence of sexism and stereotypic attitudes on their occupational choices. This model was compared to a traditional vocational exploration unit that did not include an examination of stereotypic attitudes. Three criterion measures for male and female subjects were used in this study, including the Bem Sex Role Inventory (BSRI), an occupational brief selection form, and a three-item questionnaire to evaluate the selected briefs. Additionally, female students completed the Life Style Index. The findings indicated that although no significant impact can be attributed to the experimental treatment, the sex differences found in this study may provide a point of departure for future programs focusing on increasing nontraditional options in vocational exploration. This research does call into question, however, the value of short-term programs which claim to expand nontraditional career options.     

Stigma in help-seeking: the case of adolescents

Stigma associated with seeking help has been found to be a key help-seeking barrier, however its role is less clear for: (a) adolescents, (b) groups outside the United States and (c) different types of therapy. This study addresses these omissions by examining the relationships between perceptions of public stigma of mental illness and the self-stigma of seeking help, and how they are related to help-seeking attitudes and intentions for both individual and group therapy among adolescents in Israel (N?=?238). Path analysis confirmed that self-stigma of seeking help was negatively related to attitudes towards psychological help which was then positively related to intentions to seek help, across both individual and group therapy. Consistent with the only other study conducted in Israel, but contrasting research from other parts of the world, the relationship between perceptions of public stigma of mental illness and self-stigma of seeking help was not present for either individual or group therapy. However, perceptions of public stigma of mental illness were a direct negative predictor of help-seeking attitudes for group therapy. Overall, participants reported more negative perceptions of group therapy than individual therapy. These results have implications for future interventions to increase help-seeking behaviours for adolescents.     

EMPLOYEE ATTITUDES AND CUSTOMER SATISFACTION: MAKING THEORETICAL AND EMPIRICAL CONNECTIONS

Previous research has established links between employee attitudes and customer satisfaction. Little theory has been used to help explain and build on the results of these studies. A theoretical model of the employee attitude-customer satisfaction process is proposed based on Bagozzi's (1992) model of attitudes, intentions and behavior. Employee attitudes and intentions, and customer satisfaction data from a service-oriented organization with 160 offices is used to provide an initial test of the usefulness of the model. Cross-validations of the model with and without common method variance were conducted. The results provide strong support for the model. Suggestions are offered on extensions of the model in future research.     

Reexamining the job satisfaction-performance relationship: the complexity of attitudes

The present article argues that organizational researchers tend to adopt an overly simplistic conceptualization and operationalization of job satisfaction (and job attitudes in general). Specifically, past research has failed to examine the affective-cognitive consistency (ACC) of job attitudes and the implications this has for the strength of the attitude and its relationship with behavior (e.g., job performance). Results from Study 1 suggest ACC is a significant moderator of the job satisfaction-job performance relationship, with those employees higher in ACC showing a significantly larger correlation between job satisfaction and performance than those lower in ACC. Study 2 replicated these findings. Implications for the study of job attitudes, limitations of the current studies, and multiple avenues for future research are discussed.     

Physicians in literature: Emotional approaches to patients

As evidenced in literature, physicians vary in their emotional devotion to patients. John Steinbeck's physicians are aloof. The doctors of William Carlos Williams and Richard Selzer form strong, complicated, emotional attachments to their patients. These attachments allow them to live fuller, more sensuous lives, without interfering with their proper functioning as healthcare providers. F. Scott Fitzgerald's Dr. Diver overly commits himself to a patient and suffers the consequences. The present-day physician can help modulate his own emotional connections to patients by examining these literary models.     

Development of a questionnaire on attitudes towards suicide (ATTS) and its application in a Swedish population

An instrument measuring attitudes toward suicide was developed through two postal questionnaire surveys, 1986 and 1996, approaching general population samples of 700 and 1,000 persons, respectively, and with response rates of 75% and 64%. A 10-factor model was obtained and comparisons between waves revealed an overall more permissive and pro-preventional attitude in 1996. The results implied complex relationships at the aggregated level between attitudes and suicidal behavior, depending on type of suicidal behavior, attitude factor, and subgroup. At the individual level, persons answering affirmative on own suicidal behavior, as compared to the nonsuicidal group, held a more permissive and understanding attitude toward suicide.     

Interaction Process Differences between Groups of Paranoid Schizophrenic and Depressed Patients

Group psychoanalytic treatment has special value for helping people form intimate attachments, in particular, for enabling them to resolve lifelong unconscious resistances to closeness. The group serves both as an amphitheater and as an agent for change.

As group therapists, we may break the task down into three stages. First, we bring the character resistances into play; second, we resolve the fears underlying them; and third, we empower our patients to develop mature ways of expressing intimacy.

Our task requires that we establish a contract with our patients so as to study any breach as a possible resistance to intimacy with other members. We study these resistances, which are expressed in words and attitudes. Beneath such resistances lie various fears, which we bring to the surface. As our patients resolve these fears, they begin to act toward each other as they did toward significant figures in their formative years. We work with these vestigial modes of relating, and help our patients turn them into mature modes of expression.     

From left to right: how the personality system allows basic traits to influence politics via characteristic moral adaptations

Research on the association of personality to political orientation has suggested that direct influences are modest. Here we used a personality system model in which direct influences on political behaviour flow from moral values, with personality mostly acting on these characteristic moral adaptations, rather than directly affecting political attitudes. Study 1 in 447 subjects supported this model, with significant effects on political orientation flowing from four of the five-factor model personality domains, but largely mediated through moral values concerning the importance of group order and individual rights. This personality system model was replicated in an independent study (n= 476) using a US sample and including a different measure of politics. Both studies support predictions that personality has significant effects on political attitudes, but that these are exerted largely via moral values. These findings help to explain inconsistencies in previous studies attempting to link personality to political orientation that have not included the intermediary level of values.     

Can negative attitudes toward patients with borderline personality disorder be changed? The effect of attending a STEPPS workshop

We sought to determine whether negative attitudes toward patients with borderline personality disorder (BPD) can be modified through education. Mental health clinicians attended a 1-day workshop on the Systems Training for Emotional Predictability and Problem Solving (STEPPS) group treatment program for BPD. A questionnaire to assess attitudes towards BPD was given to 271 clinicians before and after the workshop. Following the workshop, clinicians endorsed having significantly greater empathy toward patients with BPD, and having greater awareness of the distress and low self-esteem associated with the disorder. Significant improvement was seen in the clinicians' attitudes toward patients with BPD and their desire to work with them. Clinicians were significantly less likely to express dislike for BPD patients. They also reported feeling more competent in their ability to treat these patients. The study offers preliminary evidence that negative attitudes toward patients with BPD can be modified through education.     

Reaching Across the DMZ: Identity Uncertainty and Reunification on the Korean Peninsula

Drawing on uncertainty‐identity theory (Hogg, 2012), we explore the effects of uncertainty concerning a specific social identity on group identification and attitudes toward subgroup integration and separation in South Koreans' nested identity context (N = 148). All variables were measured. Path analysis revealed, as predicted, that superordinate identity uncertainty weakened superordinate identification and subgroup identity uncertainty weakened subgroup identification. We also found that subgroup identity uncertainty strengthened superordinate identification. This effect was stronger for those who perceived their superordinate group prototype and subgroup prototype to be distinct and nonoverlapping. Furthermore, superordinate identity uncertainty decreased reunification intentions by weakening superordinate identification. Subgroup identity uncertainty increased reunification intentions by strengthening superordinate identification only for those who perceived their superordinate group prototype and subgroup prototype to be distinct and nonoverlapping. Implications for uncertainty identity theory and intergroup relations are discussed.     

Group-as-a-whole concepts and the therapeutic milieu on the inpatient psychiatric unit

This paper focuses on large group process on the inpatient psychiatric unit. General systems theory and group-as-a-whole concepts are used to understand the dynamics of the therapeutic milieu. Using this information as a tool, the therapist can make various interventions on an individual and group level that will help patients understand and deal with their own psychopathology. Another benefit of this process is that it will develop a community on the psychiatric unit where patients help each other to get well. Three clinical examples are used to illustrate the relevance of this concept. With the advent of short-term psychiatric hospitalization, the therapeutic milieu has shown a drastic decline. Emphasis has been placed on the individual as opposed to the group and a valuable therapeutic tool has been lost. Using a group-as-a-whole concept can help reverse this trend and make the milieu on the inpatient psychiatric unit instrumental in the recovery of the patient.     

Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to singificantly delay relapse, reduce symptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.     

Predicting support for racial transformation policies: Intergroup threat,racial prejudice,sense of group entitlement and strength of identification

Policies and programs designed to challenge the effects of racial discrimination (such as affirmative action) are hotly contested. Factors which have been proposed to explain opposition to these policies include racial prejudice, group threat and self‐interest, and perceptions of intergroup justice. We report the results of two random national telephone surveys which tested a theoretically based model of the predictors of policy support in post‐apartheid South Africa. The results provided limited support for Blumer's group position model. Compensatory and preferential treatment policies had different underlying predictors: Violated entitlement featured in the models of compensatory policy attitudes, but not preferential treatment policy attitudes, where threat was the strongest predictor. In addition to threat and violated entitlement, policy attitudes among the black sample were related to ingroup identification but those of the white sample were related to prejudice. The effects of these variables were in the opposite directions for the two samples: Policy support was associated with strong ingroup identification and high levels of threat among the black sample (i.e. prospective beneficiaries of the transformation policies), but with low levels of prejudice and threat among the white sample. We conclude by considering the implications that these findings have for social change programs. Copyright © 2009 John Wiley & Sons, Ltd.     

United States and Japanese college students' attitudes toward seeking professional psychological help

The purpose of the study was to find how nationality, sex, and past experience of seeking professional psychological services are related to attitudes toward seeking professional psychological help. Three hundred Japanese college students and 300 US college students responded to the Attitudes Toward Seeking Professional Psychological Help (ATSPPH) questionnaire. The ATSPPH consists of four subscales: Need (recognition of need), Stigma Tolerance (the degree of tolerance against stigma associated with help‐seeking action), Openness (interpersonal openness), and Confidence (confidence in mental health professionals). As predicted, past experience of seeking professional psychological service and sex were important predictor variables of performance on the ATSPPH scales. Those who had past experience of seeking professional psychological help had more favourable attitudes toward seeking professional psychological help than those who never consulted psychological professionals. Similarly, in testing the past experience separately with the two nation groups, past experience with seeking professional psychological services was found to be a predictor of the overall attitudes toward seeking professional psychological help among Japanese and US participants. Furthermore, Japanese participants with past experience also showed greater recognition of need for professional psychological help and confidence in psychological health professions than Japanese without past experience. The degree of stigma tolerance associated with help‐seeking behaviour and the tendency of interpersonal openness, however, did not differ between Japanese participants with and without the past experience of seeking professional psychological services. The same results were also found among the US participants. In terms of sex as a predictor variable, females tended to have more positive attitudes toward seeking professional psychological help than males. There was a significant nationality by sex interaction effect. US females had significantly more favourable attitudes than the other three groups, indicating that there was sex difference in help‐seeking attitudes in the US group, but not in the Japanese group. If the sex variable is ignored, Japanese students have less favourable overall attitudes toward seeking professional psychological services than US students. Other results and limitations of the study are discussed.