Comparison of Dreams in Individual and Group Psychotherapy

This article gives specific reasons and evidence why group psychotherapy is the treatment of choice for addictions. Utilizing object relations theory and the self-psychology of Kohut, the authors present a model of group psychotherapy that combines these perspectives with those of Yalom's interactional group psychotherapy. Agreeing with Kohut and other object relation theorists, the authors view addiction as a condition that is the result of a person's misguided attempts at self-repair because of deficits in psychic structure. Vulnerability of self is the consequence of developmental failures and deprivation. Substance abuse only exacerbates this condition leading to exaggerated difficulty in regulation of affect, self-care, and characterological pathology. Abstinence is usually required as the first step in arresting this process and establishing a treatment regimen that will allow the vulnerabilities of the self to be altered and restored. This article suggests that this recovery and treatment process is best accomplished in a group therapy setting that is conducted within the guidelines of the principles of object relations theory and a modified version of Yalom's interactional group therapy format.     

The effectiveness of university counselling for improving academic outcomes and well-being

The work discusses the effectiveness of the counselling treatment to enhance student academic success. The participants were randomly assigned to either an experimental group (66 students who had completed counselling treatment) or a wait-list comparison group (44 students). The Adult Self Report (ASR) by Achenbach and Rescorla [2003. Manual for the ASEBA adult forms & profiles. Burlington, VT: Research Center for Children, Youth, & Families, University of Vermont] and the Outcome Questionnaire 45 (OQ-45) by Lambert and Hill [1994. Assessing psychotherapy outcomes and processes. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 72–113). New York: John Wiley] were applied before and after the counselling sessions. Data show statistically significant decrease in the ASR clinical scales for both internalising and externalising problems after counselling as well as in the OQ-45 scores for distress symptoms and relationship difficulties. Compared with the control group, the students who received counselling exhibited a significant recovery regarding their progress with their studies.     

The Development,Process, and Evaluation of Group Psychotherapy With Sexually Abused Preschool Girls

The development, process, and evolution of group psychotherapy specifically designed for sexually abused preschool aged females is presented. Utilization of male and female cotherapists, group structure, individual and family dynamics, the role of children's mothers in treatment, and process of treatment are examined. Issues regarding countertransference phenomena, cotherapy relations, in-depth involvement of the children's mothers, and specifics related to structuring of a time-limited group are beyond the initial intent and scope of this paper, and are not discussed here.

The cotherapists conclude that group psychotherapy for children of this age group is both clearly valuable and highly indicated as an adjunct treatment modality. In future group psychotherapy with sexually abused preschool aged children, based upon clinical experience and evaluation, the cotherapists advocate a time-limited approach whereby each session would focus upon specific issues as illustrated in Table 1, and include structured and purposeful involvement of the girls' caretakers.     

A Preliminary Report on Short-Term Group Psychotherapy on An Acute Adolescent Male Service

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.     

Preliminary Findings from a Qualitative Study of Trauma Survivors in Treatment: Changes in Personal Narratives

This article seeks to document the characteristics and themes of later trauma recovery using a grounded theory analysis of interviews with trauma survivors enrolled in outpatient treatment. Little research exists that speaks to patients’ own accounts of the process of trauma recovery. Such accounts might elucidate how psychotherapy helps survivors make and remake meaning of their lives, their experience of traumatic events, and the resources they might call on in psychotherapy to secure recovery. This study examined narrative material gathered in a series of interviews with trauma survivors (n?=?14) who had been in treatment for an average of 8 months and could be described as in a later phase of the recovery process. Two significant themes emerged from the analysis: (a) greater coherence to the trauma narrative, and (b) the emergence of a more reflective and observational stance with respect to one's history. Implications for trauma-informed therapy are discussed.     

Voices from the Inaudible: The Patients Speak by Theodor Reik

Fifty-one inpatients, hospitalized on average for 21 days, were studied by means of discharge debriefing interviews. An unstructured, mandatory, and functionally heterogeneous psychotherapy group was compared with a structured, voluntary, and functionally homogeneous psychotherapy group. Statistical analysis of the patients' valuation of the group psychotherapy experiences and of their rankings of traditional group psychotherapy curative factors were performed. Results demonstrated that group psychotherapy was a highly valued component of the overall inpatient treatment. Structural modifications aimed at increasing the here and now, and interpersonal focus of the group meetings, such as the use of patient agendas and group rehashes, significantly affected the patients' group experiences. A comparison of both types of inpatient groups with an outpatient group psychotherapy sample suggests certain guidelines for the goal setting and conduct of inpatient group psychotherapy, recognizing the specific and heterogeneous needs and capacities of the patients treated.     

The Treatment of the Young Delinquent by J. Arthur Hoyles

On the rationale that group psychotherapy focuses on interaction processes in close relationships, our study sought to investigate the hypothesis that small group therapy would be effective in enhancing intimate friendship in a dyadic relationship. The study group consisted of 102 elementary school students who had been referred for counseling help. Matched by age, sex, and similarity of problem, each pair of students was divided into an experimental group (N = 55) and a control group (N = 47). The experimental group contained eight small treatment groups and the control group contained seven matching small groups, leaving one special education group with no control. The results support our hypothesis that group psychotherapy positively affects intimate friendship of girls and boys. They further suggest the boys' need for such an experience, since without it they markedly deteriorate in intimate friendship. Implications for the group leader are derived from the correlations between gains in intimate friendship and group intimacy.     

It's never too late to change: A group psychotherapy experience for older women

Group psychotherapy in a mixed gender group is seen as useful for treatment of the unique existential and emotional problems of the older woman. This article describes the first year of a psychotherapy group for older adults, four women and three men in their early fifties to late sixties. Some issues discussed unique to this age group were loss, isolation, changing body image, and changed political views. There were differences in reactions between the men and women. The major value of group psychotherapy for older women is seen as providing a safe arena for exploring current issues, integrating a sense of self, enhancing self-worth, and overcoming isolation and despair.     

The Preoedipal Development of the Critical Superego and Its Manifestations in Psychoanalytic Group Psychotherapy

Alexithymia is a psychic dysfunction in which symbolic thinking and fantasy are reduced, somatization is common, feelings are poorly communicated, empathy is impaired, and intimate interpersonal relations are difficult to maintain. Individuals with significant alexithymia may have a variety of psychiatric disorders but their psychotherapy should always be informed by an awareness of their alexithymia. This paper reviews the concept and details the most efficient means of psychotherapy for alexithymic patients. Ideal treatment for such patients maximizes their opportunities to learn while protecting their self-esteem and minimizing nonproductive stress. Such treatment involves concurrent individual and group psychotherapy. Clinical material is presented and specific therapeutic maneuvers are explored.     

Premature termination: A risk in eating disorder groups

This study examines the influence of combined vs. conjoint psychotherapy on the phenomenon of premature termination in eating disorder groups. Thirty-eight women with a diagnosis of anorexia nervosa or bulimia enrolled in group psychotherapy were designated as group completers or premature terminators using individually defined treatment objectives. Those eating disorder patients in combined group and individual psychotherapy showed a lower frequency of premature termination than patients in conjoint group and individual psychotherapy.     

Patterns and determinants of attitudes of psychiatric residents toward group therapy

The nature and origins of psychiatric residents' attitudes toward group psychotherapy were assessed by means of a semistructured interview. Subjects were 10 PGY-4 residents from five different residency training programs. Questions focused on subjects' perceptions of the possibilities and limitations of group therapy as a treatment modality, the efficacy and dangers of combined and conjoint treatment, the nature and extent of their training experiences in group approaches, the salient characteristics of their group therapy teachers and supervisors, and the attitudes of faculty about group psychotherapy that they were able to infer. Results suggest enormous variability of residents' attitudes. Hypotheses about the reasons for such variability are offered.     

A Critique of Group Therapy Research

In this randomized clinical trial, we compared time-limited group psychotherapy and time-limited individual psychotherapy. Ninety-eight nonpsychotic psychiatric outpatients participated. There were five therapists, all highly experienced with brief therapies. Significant improvement and maintenance of improvement occurred in both treatments. Although both treatments were quite beneficial on a number of our subjective measures, there was a clear preference by patients for the individual therapy. Recommendations are offered for improving the acceptability of group treatment approaches.     

The problem of reinterpretive distortions in group psychotherapy with borderline patients

Group psychotherapy with borderline patients is challenging work. A group in which the core of patients falls within this nosological category is described. The phrase reinterpretive distortion is used to characterize an aspect of these patients' communication style which makes their effective treatment quite difficult. Examples of the phenomenon are offered, as is an explanation of the dynamics which give rise to it and the functions it seems to serve. Effective ways to deal with reinterpretive distortions in the group psychotherapy context are suggested.     

Outcome of psychoanalytically oriented group psychotherapy

A study of 100 consecutive persons who terminated, once a week, psychoanalytically oriented group psychotherapy shows that it is an effective treatment for neurotic persons with good ego strength who remain in therapy a year or longer. Analytically oriented group therapy was less effective in treating severely ego-impaired persons, and group members of all levels of ego strength often required augmentation of their group therapy by individual sessions and psychotropic medications. Early dropouts (less than 30 sessions) seemed related to lack of motivation and poor fit with the group. Later dropouts (sessions 30–60) seemed related to low ego strength.     

Homogeneous group therapy of borderline personality disorder

The authors maintained a time-limited, diagnostically homogeneous psychotherapy group of borderline patients for one year. The group progressed through prototypical stages of group development, but each phase was marked by variations of the aggressive drive and defenses against aggression that are characteristic of this disorder. The group provided a well-suited forum for the exploration of suicidal and homicidal impulses and the development of an observing ego. Despite the limits on generalizability from this group, it appears that group psychotherapy can be a valuable adjunctive modality for some borderline patients.Paper presented at the American Psychiatric Association Conference, Montreal, May, 1988.     

The Efficacy of an Integrated Theoretical Approach to Group Psychotherapy for Male Inmates

To assess the efficacy of an interpersonal process-oriented and cognitive-behavioral group psychotherapy program, 36 incarcerated male adults were assigned to either a treatment group (n = 20) or a no treatment control group (n = 16). Outcome measures consisted of paper-pencil self-report instruments, institutional behavioral data, and structured interviews with the group therapists (n = 3). Results indicated no significant changes in inmates' level of defensiveness, empathy, or institutional behavior; however, the inmates reported universally positive reactions to the treatment program. The group therapists also perceived the treatment program as efficacious, particularly in fostering a cohesive group atmosphere and increasing inmate responsibility for group leadership. Implications for practice and research are discussed.     

Editorial

Group dynamics are the elements that make group psychotherapy unique. When applied to the inpatient group, they illuminate various aspects of milieu treatment. Because of this linkage, the therapy group can be used to educate trainees about (1) systems dynamics on the psychiatric unit and their administrative implications, (2) the vicissitudes of the patient's treatment alliance with the hospital staff, and (3) the psychodynamics of severe psychopathology. In the group, individual defensive operations stand out with special clarity. Their expression is fueled by the group's dynamics. Here, internal object relations are reenacted and the defense of projective identification becomes vivid. The focus of this paper is not on the teaching of group psychotherapy itself, but rather on the use of this modality for the general training of future professionals.     

Multiple personality disorder and the choice of self: Change factors in a brief therapy case

A person who identified herself as having a multiple personality disorder made remarkable changes after seven psychotherapeutic sessions and two batteries of tests, one on the alter. The case raises such problematic issues as the diagnosis of MPD, the unitary versus discrete theories and treatment of it, change factors in brief psychotherapy and for all psychotherapy, and the use of psychological tests.     

Bridging the gap between long- and short-term group psychotherapy: A viable treatment model

The purpose of this paper is to support the efficacy of short-term insight-oriented, process group psychotherapy and to present a unique treatment model. The format for a time-limited, dynamic group therapy model with the opportunity to recontract for additional segments will be discussed. Evidence will be presented that supports the effective use of this model for providing continuity of care for patients with both long- and short-term treatment goals. The referral process,contracting for appropriate goals, group development, the cotherapy relationship, and other specific treatment issues will be addressed.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.