Editor's Introduction

This editorial introduces a series of articles by leading proponents of the ten major models of group psychotherapy to appear in the International Journal of Group Psychotherapy. These theoretical contributions will be published throughout 1992 as a dedication to the American Group Psychotherapy Association's (AGPA) 50th anniversary. In the present article, the author reports results from a recent survey of senior clinicians within AGPA who expressed their opinions about the central issues that practitioners should understand during the working phase of group treatments. Statistical comparisons among action-oriented, interpersonal, and psychodynamic respondents to the questionnaire revealed striking differences in how therapeutic interventions were conceptualized. These findings are outlined as a preface to the first three articles in the series.     

The future of the American Group Psychotherapy Association: whither we goest?

The author describes his perspective about what the future holds for the American Group Psychotherapy Association (AGPA). Utilizing Nitsun's (1996) construct of the "anti-group" as an organizing metaphor, he delineates the destructive forces both within and outside the organization that are currently affecting it, and then describes how they can be transformed into instruments for positive development. He suggests that the AGPA can and must continue to provide a "holding environment" (Winnicott, 1960) for professionals interested in working with people in groups. In addition, he asserts that the organization will build upon its remarkable response to the September 11, 2001 debacle in the United States to expand its services to those who have been traumatized. Beyond this, he underscores the importance of the AGPA consolidating and expanding its various educational offerings into a coherent package that will meet the needs of any and all who are interested in learning about how to work effectively with groups. In these and other ways, he contends that the AGPA will thereby confirm Nitsun's assertion that anti-group forces can be transformed, and that organizations that confront these forces constructively can not only survive but thrive.     

Reading Plays to Enhance Professional Development

Writing in a narrative style, the authors describe the continuing education model of the Red Well Theater Group. The model combines a study group format with a play reading performance module to enhance the professional development of the Group’s members and their audiences of colleagues. The educational goals are to: 1) didactically study the principles and practice of group therapy; 2) theatrically illuminate concepts, relational themes, and small group dynamics relevant to group therapy; 3) experientially deepen therapist empathy for the challenge of being in a group; and 4) provide a vitalizing experience in support of therapist well-being. As an example of this model in action, the authors elaborate their experience preparing The Great God Pan, by Amy Herzog, for presentation at the 2014 American Group Psychotherapy Association (AGPA) Annual Meeting.     

Life's many pieces: the identity of the group psychotherapist

The American Group Psychotherapy Association (AGPA) and its members are experiencing a trauma in response to the changes in health care imposed by the managed care industry. Although the economic threat is frightening, the threat to professionals' and AGPA's identities is even more damaging. The increasingly rapid, society-wide rate of change and factors related to the aging of AGPA's membership complicate its ability to cope with the trauma. The author recounts personal trauma and professional experiences in treating traumatized individuals, and proposes that when certain needs are met, growth can occur as part of a healing process: getting through the trauma, finding safety, self-soothing, and achieving mastery. AGPA resources for being safe, self-soothing, and achieving mastery are described. AGPA has been successful in reaching out via new accomplishments in regard to visibility, although the understandable impulse to withdraw may be impeding efforts to diversify the membership body. The author urges fighting against the pull to withdraw and expresses hope that the AGPA will cope well with the trauma by using its significant resources and will ultimately experience a beneficial change in its identity.     

At the core: how we steer our course

"The force that through the green fuse drives the flower drives my green age..."--Dylan Thomas (1952). The beautiful evocative words of Dylan Thomas speak to the driving life force that pulses through all creation. So what, then, drives our organization, the American Group Psychotherapy Association (AGPA)? What underlying stream can we tap into to provide the energy, power, and vitality we need to go on being in a meaningful and productive fashion? And, what internal compass can we rely on to steer us in the right direction, to guide us in how we function as an organization? My purpose here is to consider how we formulate our objectives, determine our priorities, make decisions, and insure, as best we can, that we are pursuing that which is meaningful and essential, not veering drastically off course. To do this, I would like to focus briefly on the current organizational structure of AGPA, then examine the use of a strategic planning process, review our accomplishments, and lastly explore hopes and dreams for our future as the premier group psychotherapy organization in the United States.     

Reflections on a developing body of group-as-a-whole theory for children's therapy groups: an introduction.

This essay serves as an introduction to a collection of articles on group psychotherapy for children that appears in the following pages. These articles are an outgrowth of a symposium on children's group treatments presented at the 1990 Annual Conference of the American Group Psychotherapy Association. The present author provides a general overview of relevant literature and offers an orientation to the subsequent theoretical and practical integrations.     

The Hispanic Female Adolescent: A Group Therapy Model

This essay serves as an introduction to a collection of articles on group psychotherapy for children that appears in the following pages. These articles are an outgrowth of a symposium on children's group treatments presented at the 1990 Annual Conference of the American Group Psychotherapy Association. The present author provides a general overview of relevant literature and offers an orientation to the subsequent theoretical and practical integrations.     

Zur Bedeutung von Gruppenleitern in der gruppenpsychotherapeutischen Weiterbildung

Training in group therapy is fundamentally based on self-experience in groups. The importance of the model character of the group leader's role has hardly been subject to empirical research in spite of its highly qualified and specialized requirements. In order to ensure process quality in group therapy training, the effects of the leader's model on the reported learning effects of 413 members in 35 short-term Process (self-awareness) and so-called Special Interest (thematically focused) groups of the American Group Psychotherapy Association (AGPA) were investigated. The first two sessions out of four were investigated by process questionnaires focusing on self-experience, experience of the group atmosphere and subjective impressions of the group leaders' performances. These process variables were later correlated with the overall learning impression after all four sessions. It turned out that particularly those group leaders' styles and attitudes had a strong positive correlation with favourable learning effects, that were decisive and charismatic instead of vague and that group leaders who were experienced by group members as predominantly indecisive, vague and less charismatic were in spite of the fact of being seen as competent and skillful produced weak learning effects. Results are discussed in the light of the need of neophyte group therapists to identify with a leader model promising to provide authority and sovereignity even prior to competence and empathy given the anticipatory fear regarding possible critical group dynamics in future therapy groups.     

“Revolving Doors and Brief Encounters: Dare We Do Inpatient Groups?” Reflections on Being an AGPA Conference Panelist

Participating as an American Group Psychotherapy Association (AGPA) conference panelist is an impactful and noteworthy experience. The purpose of this article is to discuss the experience in the context of providing a brief update to the conversation regarding rapid turnover in inpatient groups. We aim to highlight and summarize the far-reaching impact of ongoing clinical discussions and research found in both the literature and the conference experience. From an integrative perspective, clinical discussion between colleagues is an essential component in the discipline of psychology. It aids in appropriate edification as a clinical psychologist. Rather than emphasizing a one-size-fits-all therapeutic model, if we remain open to a diversity of approaches while clarifying and fine-tuning the most valuable commonalities, we will subsequently facilitate increased professional and patient satisfaction.     

Systems-centered training groups' process and outcome: a comparison with AGPA institute groups

In this quasi-experimental study we compared the process and outcome of six experiential Systems-Centered Training (SCT) groups to those of American Group Psychotherapy Association (AGPA) Institute groups from two prior studies (MacKenzie, Dies, Coche, Rutan, & Stone, 1987; Tschuschke & Greene, 2002). The SCT training compared well overall and the results provided preliminary, indirect support for the usefulness of "functional subgrouping" - SCT's conceptual and methodological bridge between the group-as-a-whole and the individual member. However, quasi-experimental design limitations make other interpretations equally plausible. Within-group change in the process variables for the SCT groups was also explored, as well as the relative contributions of these variables to post-training learning outcomes and anxious and depressive experience. The results partly corroborated prior studies, but also suggested that SCT may alter training group dynamics, learning, and emotional experience in ways consistent with SCT theory.     

Keeping a group psychotherapy program alive and well within a psychiatric residency

A mandatory year of outpatient group therapy training is an accepted part of residency training in psychiatry. Residents need stable groups to lead in order to have a satisfactory training experience. A solid group program is integrated and cohesive. A group therapy coordinator has to consider the following factors in developing and maintaining the optimum program: sanction from the department of psychiatry; integration of the program into the system; transfer of groups from one class to another; personal screening and followup of all referrals; availability to professionals in the community; coordinator participation in relevant group therapy classes; a vehicle for supervisors to collaborate with each other and administrator; and a format for all members of the group program community to interact.This paper is an elaboration of a symposium presentation, Training in Group Psychotherapy: The Quest for a Viable Model, AGPA Annual meeting, 1990.     

An Introductory Course in Group Psychotherapy in The Netherlands: Use of a Knowledge-Sampling Test

Abstract

We offer comments regarding two articles in this issue, one titled “Bridging the Practitioner-Scientist Gap in Group Psychotherapy Research” and a complementary article providing the results of a survey, entitled “A Survey of Canadian Group Psychotherapist Association Members” Perceptions of Psychotherapy Research.’ We also make several recommendations for collaborative research between practitioners and scientists, such as the inclusion of clinicians on the research team, practice research networks, and improved approaches to communicating clinically relevant research findings. Also discussed are reflections and recommendations from the authors’ experience as scientist-practitioners.     

Meta-analysis of medical self-help groups

Self-help groups (SHGs) may rival all other forms of treatment sometime within the next century (see Goodman & Jacobs article in "The Handbook of Group Psychotherapy," Wiley, 1994), though the "purist" model of SHGs seems inaccurate because many professionals are actually involved. Although traditional forms of group treatment have kept pace with empirical research (Fuhriman & Burlingame, "The Handbook of Group Psychotherapy," 1994), SHGs have not. In particular, medical SHGs, often promoted by hospitals as viable treatment alternatives, have no systemized database from which to draw conclusions about overall effectiveness compared to traditional group therapies. A preliminary assessment of this area is presented using a meta-analysis of articles culled from a comprehensive review of the literature from 1970 to 1997. Results indicate that although the posttreatment analysis produced no significant differences between active and control conditions, pre to posttreatment scores indicated that SHGs produced higher patient improvement when compared to the control condition. Future implications for research and use of medical SHGs are explored.     

The unconscious ego-ideal and analytic group psychotherapy

The theoretical position of this paper is that the essential character of the ego-ideal, a part of superego functioning, is unconscious, universal, and functions automatically. Precursors to superego development and ego-ideal formation begin at early preoedipal levels, and derivations in adult behavior contain primitive aspects. Ego-ideal is perfectionistic and impossible to obey;therefore, projection of this phenomenon as well as its activity leads to disappoinment, anger, anxiety, depression and despair. Pseudomoral injunctions frequently rationalize and disguise early primitive aspects of unconscious superego development and ego-ideal formation. These points are illustrated by clinical material, showing the therapeutic action in the group which leads to a modification of this critical, self-defeating aspect of adult functioning.Copyright, 1987, Washington Square Institute for Psychotherapy and Mental Health, which published this paper in No. 14 of the Group Psychotherapy Monograph Series, after the paper had been presented at the Fourteenth Annual Conference of the Group Psychotherapy Department, and presented by invitation at the ninth congress of the International Association of Group Psychotherapy, Zagreb, Yugoslavia, August 1986.Dr. Edwards was formerly an Associate Supervisor and Faculty Member in the Group Department at the Postgraduate Center for Mental Health.     

Operationalisierte Basisdokumentation von Gruppenpsychotherapien

It can be assumed that group psychotherapy will play an increasingly more important role for both inpatient and outpatient basic care not only due to health economic considerations. This means that new methods of documentation, quality management and optimization of group-specific therapy processes and results have to be developed. The present system for operationalized basic documentation of group psychotherapy (OBG) is not only meant to be a starting point for research on dynamics and efficacy of group psychotherapy but could also serve as an instrument for standardized documentation of clinical progress, quality assurance and, in combination with the accompanying manual, as an aid for education and further training for psychotherapists. The contents of the documentation system are based on the current state of scientific research and, as far as possible, were implemented irrespective of specific psychotherapeutic approaches referring to particular schools of thought. Particular consideration was given to the practice guidelines for group psychotherapy of the American Group Psychotherapy Association (AGPA) published in 2007. The system structure is based on a model of anatomy and physiology of a group according to Burlingame et al., which ascertains patterns and processes within groups. In addition to general thematic and methodological aspects, several items on group dynamics are included, such as distribution of roles, formation of subgroups, development of group norms, conflict management, interpersonal feedback, self-disclosure, cohesion and other so-called therapeutic factors. Clinical testing in different settings is currently being carried out. Results and further developmental possibilities of the OBG system will be reported soon.     

Training in group-analytic psychotherapy in Europe

Group-analytic psychotherapy focuses on the making and maintaining of close, emotionally fulfilling relationships. Its practitioners attempt to fuse an individual and a whole-group perspective, and seek to provide the enabling conditions for freer communication between group members. The group-analytic approach is widely used in the United Kingdom, and many experiential groups on psychotherapy training courses are conducted on group-analytic lines. The Institute of Group Psychotherapy in London recognizes eight one-year courses in England and Scotland specifically oriented to group-analytic theory and methods. These courses provide an introduction to group psychotherapy to over 300 professionals of varied backgrounds every year. There are also two courses in the United Kingdom that provide a full training in group-analysis and group-analytic psychotherapy, and 11 courses on the continent of Europe. The number of courses is growing and there is now a European Group-Analytic Training Network providing formal links between them. Results of a postal survey indicate that few (10%) attenders at a one-year course have a negative response and that many (85%) recommend the course to colleagues. The efficiency and therefore reduced cost of group teaching and the incorporation of a group experience may be contributing factors to the increasing demand for this type of training.This paper is based on a presentation at an Open Session on Training in Group Psychotherapy: The Quest for a Viable Model at the American Group Psychotherapy Association Annual Meeting, Boston, February 1990. This paper represents the author's own views and is not an official statement of the Institute of Group Analysis [London]. However, members and staff of the Institute have made helpful contributions to the author in preparing it. He is especially grateful for the assistance of Mrs. Liesel Hearst (Chairperson, Overseas Training Sub-Committee, Institute of Group Analysis, London), Dr. Keith Hyde (Convenor, Manchester Course in Group Psychotherapy), Fr. Jim Christie (Convenor, Glasgow Course in Group Psychotherapy), and Dr. Vivienne Cohen (Chairperson, Training Committee, Institute of Group Analysis, London, in preparing this paper. The questionnaire study was conducted with the assistance of the Training Section of the North-Western Regional Health Authority.     

A multiple group psychotherapy approach to adolescents with psychiatric and substance abuse comorbidity.

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.     

Group psychotherapy with alcoholics: Interface with self-help groups

This paper addresses recovering alcoholics' concurrent involvement in psychotherapy groups and self-help groups. A developmental model of alcoholism group psychotherapy is presented, differentiating between early and advanced sobriety. Psychotherapy and self-help groups are compared and contrasted. Multiple group membership entails various areas of compatibility. Divergence and conflict result from differences in underlying conceptual framework and approach. Clinical implications of members' involvement in partially discrepant group settings are explored with an emphasis on transference and countertransference reactions. Multiple group membership is identified as a salient factor in alcoholism group psychotherapy at all levels of recovery.She is also in private practice.This paper was presented at the American Group Psychotherapy Association Annual Conference, Boston, February 1990.     

Introduction to Psychiatry by O. Spurgeon English and Stuart M. Finch

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.