Outcome in short-term group psychotherapy

This study examines the effectiveness of planned dynamic short-term group psychotherapy in a health maintenance organization setting. The groups, conducted by experienced short-term psychodynamically trained therapists, focused on common life-stage issues. A pretest/posttest design was employed; group participants completed a battery of self-report measures before, after, and 4–6 months after treatment. Group participants made statistically (and clinically) significant positive changes on the majority of change measures. They saw themselves as improved on target problems, became far less symptomatic, and reported considerable growth in interpersonal functioning.     

Group-as-a-whole interpretations in short-term group psychotherapy

The usefulness of therapists making group-as-a-whole interpretations in long-term group therapy was actively debated in the 1960s and 1970s. Advantages and disadvantages were delineated. An often-cited survey study of therapy groups that had emphasized group-as-a-whole interpretations found that many patients were dissatisfied with the therapist’s technique and the outcome of therapy. Although group-as-a-whole concepts subsequently became a part of the theory of many orientations of group therapy, there has appeared to be reluctance among many therapists to make group-as-a-whole interpretations, especially in short-term group therapies. Contrary to this tendency, an argument is made and a case illustration presented, which advocate the use of group-as-a-whole interpretations in short-term group therapies.     

Significant events in a psychodynamic psychotherapy group for eating disorders

This qualitative pilot study was designed to identify and explain significant events for patients participating in a psychodynamic psychotherapy group for eating disorders. Specifically, seven members of a mixed (i.e., anorectic, bulimic, obese) eating disorders group recorded what they perceived as the three most significant events in group meetings for 14 weeks. In addition, group members were instructed to record why each event was significant. Manifest and latent content analyses of the data revealed that members found feedback and observing others the two most common types of significant events, and emotional experience, insight, and relationship the reasons these events had such impact. The implications of these results for working with the eating-disordered patient in group, as well as their implication for general group theory and practice, are discussed.An earlier vesion of this paper was presented at the 1991 meeting of the American Group Psychotherapy Association, New York. This paper was funded, in part, by a California State Faculty Support Grant and a Santa Barbara Cottage Hospital Research Grant awarded to the first author. The authors would like to thank Sean T. Casey, Sally Barton, Dr. Allison Wollitzer, Tom Knowlton, Craig Park, and Beth Buxton for their assistance in the preparation and execution of this study.     

Results of short-term group psychotherapy of schizophrenic patients

A seven-week group-centered dynamic therapy course was conducted with 12 patients within the framework of a long-term treatment for schizophrenic patients. The purpose and method of treatment and the course of the group sessions are described. Analysis of the Freiburg personality inventory yielded no changes; the degree of agreement between the group mean profile and that of neurotics was striking. Analysis of the Frankfurt complaint questionnaire (Suellwold) revealed a reduction in the number of affirmative answers during and after treatment. The treatment is considered to have had positive results, although it has to be embedded in a more comprehensive treatment plan with supportive individual psychotherapy, psychopharmaceutic treatment and sociotherapy.     

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.     

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.     

Therapeutic factors in group psychotherapy: A contemporary view

This paper reviews the two major approaches to the assessment of therapeutic factors in therapy groups: 1) questionnaires administered at termination, and 2) postsession Critical Incident reports. The major categories will be discussed, and a new study utilizing Critical Incident methodology reported which replicates previous results. Suitable studies will be reanalyzed from the standpoint of the change in therapeutic factors over time as a group develops. It is recommended that the Critical Incident methodology be further refined and used in preference to the questionnaire approach.     

Therapeutic alliance and cohesion variables as predictors of outcome in short-term group psychotherapy

The current study explored the relative ability of aggregate therapeutic alliance and cohesion variables to predict short-term group therapy outcome. Data were collected from a comparative trial of two forms of time-limited group psychotherapy for complicated grief (Piper, McCallum, Joyce, Rosie, & Ogrodniczuk, 2001). The therapeutic alliance and elements of the cohesion construct were measured from the perspectives of each patient and the group therapist at intervals during the groups; scores were aggregated across assessments. Hierarchical multiple regression analyses, adjusting for the effects of treatment approach (interpretive vs. supportive) and specific group membership, demonstrated that the patient-rated alliance was a consistent predictor of outcome. Two cohesion measures, reflecting other participants' (therapist, other members) views of the patient's "fit" with the group, also accounted for variation in outcome. Implications of the findings for research and clinical practice, and the limitations of the measurement approach taken in this study, are considered.     

A controlled study of effectiveness and patient suitability for short-term group psychotherapy

A controlled, clinical trial investigation of short-term psychoanalytically oriented group psychotherapy (STG) was conducted which included eight psychotherapy groups led by experienced therapists. Patient psychological mindedness (PM) was investigated as a selection criterion and prognostic variable. Seventy-nine psychiatric outpatients experiencing prolonged or delayed grief reactions were matched for level of PM and then randomly assigned to STG or a wait list. There was repeated measurement of several areas and sources of outcome. Results indicated a strong main effect for STG but not for PM on outcome, and minimal evidence for an interaction effect. Benefits were maintained at six-month follow-up. Psychological mindedness emerged as highly predictive of attrition. A clinical discussion is presented wherein the efficacy of STG is considered as reflecting a good patient-treatment match.     

A comparison of curative factors in different types of group psychotherapy

The authors have constructed a Dutch version of Yalom's "Questionnaire for Curative Factors." This Dutch version has been administered to 134 participants of 22 psychotherapy groups in various psychiatric services in the Netherlands. Results concerning validity and reliability of the instrument are presented, as well as concerning the homogeneity of the hypothesized "factors." Differences between types of groups and categories of group members were tested by means of techniques of analysis of variance (ANOVA). Multiple regression analysis was applied in order to detect variables of differential qualities on one or more factors. Only the factor identification, neglected in literature on curative factors, was highly predictable.     

Countertransference in group psychotherapy

This paper attempts to up-date our understanding of countertransference in the therapy group setting. After a brief review of some of the psychoanalytic and the group psychotherapy literature dealing with countertransference, the paper points out the vulnerability of the group therapist and presents examples of possible countertransferential situations, such as stereotyped roles, reactions to external aspects of patients, and therapists' insecurities. It concludes by suggesting ways in which group therapists can become more sensitive to their countertransferences.     

Hostility in group psychotherapy

To run a psychodynamic group therapeutically, the leader must understand the meanings and functions of hostility. Fundamental to this task is the leader's awareness of his or her bias toward hostility as a constructive or destructive feeling and willingness to serve as a lightening rod for it. This paper discusses the sources of hostility during different stages of group development. The therapeutic handling of hostility is discussed under the following topics: theoretical considerations, defensive functions, and communicative functions. Case examples illustrate the proper handling of contractual violations, scapegoating, and narcissistic injury. Countertransference reactions to anger and rage in the group are discussed.