Trauma, Shame, and Group Psychotherapy: A Self Psychology Perspective

This paper attempts to define trauma from a self psychology/intersubjective perspective and explores shame as a basic aspect of trauma. Self psychologically oriented group therapy is examined as an effective treatment modality for dealing with issues of shame as well as the after effects of trauma.     

Ethnicity, Culture, and Group Psychotherapy

Ethnicity and culture have great therapeutic import in the practice of group psychotherapy, especially given the increasing diversity of the population of North America, and this issue has not received appropriate recognition in the literature. In this paper these terms are defined, and the literature is reviewed. Ethnicity, culture, and psychopathology are discussed, focusing on treatment issues including transference, countertransference, resistance, group cohesion, group process, and multi-ethnic groups. The group therapist must be knowledgeable about ethnic and cultural issues in the lives of the group members in order to promote group cohesion and therapeutic effectiveness. The recognition and exploration of ethnic/cultural differences enhances the work of the group. Recommendations for treatment are discussed.     

Chaos, Group Psychotherapy, and the Future of Uncertainty and Uniqueness

This paper explores the application of chaos theory, a new non-linear dynamical theory, to the understanding of psychotherapy groups. Two features of psychotherapy groups that have been insufficiently described or explained, uncertainty and uniqueness, are considered in the light of the chaos theory notion that groups proceed through periods of order and disorder. The recommendation is made that chaos theory be explored further as the field moves into the millennium and a hundred years of its own existence.     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Experiential Group Psychotherapy Supervision

Following a review of various traditional models of supervising group therapy, an experiential model of supervising group in a group setting is presented. The model stresses the group aspect of the supervisory process, encourages group interaction, here-and-now responses and associations, and employs concepts from both object relations and group-as-a-whole theory to understand what is taking place. The model's premise is that case material presented in a supervision group stimulates parallel material in supervisees, which is then used to elucidate what has taken place in the therapy group being presented. Excerpts from one supervisory group are used to illustrate major features of the model.     

Group Psychotherapy in the Context of Cultural Diversity

The authors review the salient issues involved in therapy with culturally diverse populations. They present a framework where group therapy addresses those issues. Clinical vignettes from each of the authors serve to illustrate the power of group therapy with ethnocultural populations.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

The Future of Training and Credentialing in Group Psychotherapy

High-quality group psychotherapy training is seen as more important than ever in the current health care environment. The training opportunities available at present are assessed. It is argued that there is a body of knowledge about generic group psychotherapy that can and should be taught, and that there are appropriate people to teach it. Credentialing is discussed, and it is suggested that the assessment of actual work in clinical situations must be emphasized if such efforts are to be meaningful.     

Cultural Psychotherapy: A Consideration of Psychosocial Class and Cultural Differences in Group Treatment

Most psychotherapists are aware of the many social issues and cultural factors that influence development throughout each individual life. Human nature, being a social nature, exists within relationships to others, the community, and a culture, sometimes a mixture of cultures. One social parameter, social class, redefined here as psychosocial class, has not received the same attention from psychotherapists as gender issues or ethnicity, two other important sociocultural spheres of influence on everyday life. It is suggested that group therapists are in a unique position to develop a cultural psychotherapy that addresses psychosocial class and cultural aspects of mental health. This paper includes a preliminary model of cultural psychotherapy that highlights the psychology of social class and culture for psychodynamic group psychotherapy.     

Self-Acceptance Group Therapy: A Transdiagnostic,Cognitive-Behavioral Treatment for Shame

Shame has broad importance to psychological problems. However, few interventions specifically address shame, and most of these have been designed to target shame in the context of particular disorders. Self-Acceptance Group Therapy (SAGT) was developed as a transdiagnostic shame-focused treatment, based on a cognitive-behavioral framework. SAGT is an 8-week treatment that involves psychoeducation and training in the use of cognitive and behavioral shame regulation and support-building skills in order to promote self-acceptance. After describing SAGT, the study presented used an open trial design to examine the utility of SAGT for addressing shame, self-acceptance, quality of life, and relevant psychological problems (e.g., depression, social anxiety). Twenty-four outpatients with elevated shame were assessed at pretreatment, posttreatment, and 1-month follow-up. By post-treatment, results revealed significant improvements in self-acceptance, shame, and borderline personality disorder (BPD) symptoms among treatment completers (n = 18), with all of these improvements maintained at follow-up. Additionally, significant improvements in quality of life, emotion dysregulation, depression, loneliness, and stress were observed at follow-up. Results provide preliminary support for SAGT’s utility in the treatment of shame and related pathology among diverse outpatients.     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

精神科住院患者团体心理治疗准备性会谈与治疗后访谈初探

精神科住院患者团体心理治疗较门诊患者团体心理治疗存在临床情境的特殊性,本研究探索将准备性会谈与治疗后访谈纳入治疗计划,治疗前向患者普及住院治疗、心理治疗的知识,澄清团体心理治疗的形式、目标、内容,了解患者对团体心理治疗的疑问、期望,允许患者做出是否参加治疗的决定,并在治疗后的访谈中强化疗效因子。     

Beyond Emotional Intelligence at Work:: Adding Insight to Injury Through Group Psychotherapy

The author applies the popular concept of Emotional Intelligence (EQ) to the group treatment of work problems. Adding psychodynamic insight to the existing EQ dimension of understanding emotions and utilizing emotional awareness, helps patients improve their reactions to problematic situations and individuals. By focusing on discordant episodes that arise in group, the author employs a systematic approach to identifying unconscious contributors to diminished job performance. Methods for assessing deficits in EQ and for processing relevant group discords are described. Clinical illustrations are provided.     

Shame,Death, and Dying

This paper deals with the influence of shame on the way in which Western society, particularly North America, is coping with death and dying. From being a familiar event, death and dying have become a shameful aspect of life. Thus, this paper provides some understanding of this important transformation, and it challenges some of our present attitudes regarding death and dying. These human experiences are not the ultimate manifestation of a failure, either from a personal or a medical perspective, but the only way through which human beings acquire the fullness of life, as Christian faith reveals.     

Women,Mental Health,and Managed Care

Abstract

Managed care has changed the way that mental health care is provided. These insurers manage such factors as length and type of therapy made available, access to therapy, and level of payment for therapy. Women, as the majority of those insured by managed care and as consumers of mental healthcare, are differentially affected by these changes.     

Group-Based Psychotherapy Integration in Theory and Practice: Therapeutic Community Revisited

A group-based theoretical integration model presented in this journal (F. Knobloch, 1996) is elaborated in practice. The core aspects of the group-based system are described and illustrated with clinical examples as they apply to a modified therapeutic community: (a) the creation of the therapeutic world to represent real life and its multiple realities; (b) the group schema model as a context for problem identification and exploration; (c) the collaboration between therapists and group members; (d) the exploration and experimentation of problems through individual and group tasks; and (e) the transfer of new behaviors to real life situations and (f) the systematic application of major psychotherapy theories and techniques.