Observations on Long-Term Group Therapy with Suicidal and Depressed Persons

ABSTRACT: A long-term, open-ended group for depressed and suicidal individuals who had made suicide attempts is described. Two hundred persons participated in the sample groups over a 46-month period, with only 10 suicide attempts and 1 suicide occurring in this high risk group during the period of the study. Our observations corroborated some findings and differed with others reported of experiences with groups of individuals who have manifested suicidal behavior. The paper includes recommendations for starting groups of suicidal persons and emphasizes that this method of therapy appears to be an effective mode of suicide prevention.     

儿童对所属同伴团体的选择和适应

为探讨儿童所属非正式同伴团体的选择和适应过程,选择469名小3、初1学生参加了为期2年的追踪研究.儿童同伴团体和学校适应(社会行为、社会适应、学习适应)的资料取自包含同伴评定、教师评定和学校记录多种渠道.研究发现,(1)儿童选择与自己在学校适应方面相似的同伴组成同伴团体;(2)同伴团体不仅在成员构成还是在学校适应的团体特征上具有中等程度的稳定性;(3)儿童在初测时所属同伴团体的社会能力越强、社交性越高、学业成绩越优异,则其两年后在这些方面的表现也越好,如果所属同伴团体存在同伴拒绝或学业问题,则儿童在两年后被同伴拒绝和出现学业问题的可能性也越大.     

Putting Communication into the Study of Group Memory

In the spirit of viewing human memory as a social process, Pavitt (2003) revisited the idea of group memory—recollection of information that occurs collaboratively in groups. This paper outlines and supports Pavitt's 5 major points about group remembering: (a) groups outperform individuals, (b) communication allows the group to know all knowledge of its members, (c) groups do not perform as well as a rational model predicts, (d) process losses increase as group size increases, and (e) group interaction does not guarantee optimal performance. The research on which these conclusions are based examines group memory in a simple input‐output function. Communication scholars may extend the group memory literature by studying the structure and content of discussion during collective remembering.     

Process and Content in a Therapy Group for Bipolar Outpatients

Although the literature suggests that homogeneous therapy groups are useful for bipolar outpatients, little is known about the process in such groups. Using the GCQ-S and a content analysis of discussion topics, we evaluated group process during the first 31 sessions of an outpatient bipolar group. Compared with normative samples, our group scored significantly higher in the Engaged dimension and significantly lower in the Avoiding and Conflict dimensions and in the anxiety/tension scale. Furthermore, 81% of the discussion topics were related to the three group goals, and an additional 18% dealt with general group issues such as orienting new members and attendance. The results from this pilot study suggest that bipolar patients can discuss relevant issues in a homogeneous group environment that is cohesive, open, and safe.     

Group Assertion Training with Adolescents

The effect of group assertion training was assessed with junior high school boys and girls. Adolescents identifies as unassertive were divided into treatment, placebo, and control groups. The assertion training occurred over a period of two weeks. Compared with placebo and assessment-only groups, the assertion-training group showed increased assertiveness in a role-play situation. The increased assertiveness and generalization of skills were maintained two weeks later.     

Reading times and adaptive styles among patients diagnosed with psychosis as assessed by the Serial Color-Word Test

The present study focuses on how patients diagnosed with psychosis deal with a conflicting situation. In the study, two groups of patients were assessed. One group consisted of patients diagnosed with psychosis (n = 41), while the comparison group (n = 135) consisted of inpatients diagnosed either with anorexia nervosa or with bulimia nervosa. The groups were assessed using the Serial Color Word Test (S-CWT), designed for studying an individual's successive adaptation over time to a conflicting situation. The S-CWT differentiated the two groups regarding both reading time and adaptive styles. Patients diagnosed with psychosis had longer reading times and an adaptive style that was deviant throughout the test, indicating poorer cognitive functioning and more serious psychopathology. These problems may in turn influence functioning in work or study and daily living, all of which are important in treatment planning.     

Communication of Confidence as a Determinant of Group Judgment Accuracy

The performance of interacting groups is often viewed as a function of the groups' ability to identify and weight their better members' judgments (Einhorn, Hogarth, & Klempner, 1977). Accurate identification of the best group member is facilitated by individuals accurately assessing confidence in their own individual judgments and accurately communicating their confidence during group interaction (Sniezek & Henry, 1989). This paper examines the communication of confidence in interacting groups in two ways: by observing the performance of interacting groups for which confidence is anticipated to be communicated with high accuracy, and by observing the effects of changes in the group interaction setting that vary group members' ability to communicate confidence. This is achieved by examining the performance of a special type of interacting group, a laboratory financial market, that encourages relatively accurate communication of confidence and that can be modified to manipulate the extent to which confidence can be communicated. Results reveal generally high performance of groups which interact in settings that are conducive to communication of confidence, and significant learning from the interaction process by all group members (including the best member). Results also indicate a significant decrease in the performance of groups whose ability to communicate confidence during interaction is reduced.     

Model Reinforcement in Group Counseling with Elementary School Children

This study investigated the effectiveness of model reinforcement and reinforcement group counseling with elementary school children using sociometric status as a criterion. Eighteen low sociometric students experienced group counseling with sociometric stars included as models (six groups); 18 others experienced group counseling with all low sociometric students (three groups); and a control group met for an activity period. An analysis of co-variance was computed to measure the difference of change in social acceptance among the three treatments. The findings indicated that low sociometric students in the model reinforcement groups made significantly more gain in social acceptance than either those receiving counseling without models or the control group. A two-month follow-up showed the sociometric gains were retained.     

Countertransference in the Group Psychotherapist

This report describes a pilot study of a waiting-list group (preliminary process group [PPG]) that provided treatment for applicants to a university affiliated, urban mental health center. All individuals on the treatment waiting list were informed of the PPG. This semistructured group, meeting weekly, began with members presenting their problems, followed by free discussion, and ending with goal setting for the next week. Approximately one seventh (35 out of 262) of the clinic's applicants during a 4½-month period chose to enter the PPG. They differed from those who chose not to particpate (wait list) by being older and less educated. Approximately 80% of both wait-list and PPG participants subsequently entered therapy. Significantly more PPG patients than those on the wait list entered group treatment. The PPG served clinic needs by providing prompt service for self selected individuals and by supporting the group therapy program.     

Group Work with Aggressive Men: Group Within a Group Within a Group

Psychodynamic group therapy offers many opportunities for members to identify, understand, and change the underlying problems, which lead to their aggressive behavior. In addition, group therapy can help to improve the members’ interpersonal relationships. The “Coping with Aggression” is comprised of three groups. A psychodynamic group of assaultive men made up the first group. The second group consisted of two leaders and a consultant whom the group members knew about but never actually met. The observers who sat outside the group made up the third group. Therapy contracts, boundaries, and leadership, and group process are discussed.     

Improving the Accuracy of Group Judgment: A Process Intervention Combining Group Facilitation,Social Judgment Analysis,and Information Technology

Interacting groups fail to make judgments as accurate as those of their most capable members due to problems associated with both interaction processes and cognitive processing. Group process techniques and decision analytic tools have been used with groups to combat these problems. While such techniques and tools do improve the quality of group judgment, they have not enabled groups to make judgments more accurate than those of their most capable members on tasks that evoke a great deal of systematic bias. A new intervention procedure that integrates group facilitation, social judgment analysis, and information technology was developed to overcome more fully the problems typically associated with interaction processes and cognitive processing. The intervention was evaluated by testing the hypothesis that groups using this new procedure can establish judgment policies for cognitive conflict tasks that are more accurate than the ones produced by any of their members. An experiment involving 16 four- and five-member groups was conducted to compare the accuracy of group judgments with the accuracy of the judgments of the most capable group member. A total of 96 participants (48 males and 48 females) completed the individual part of the task; 71 of these participants worked in groups. Results indicated that the process intervention enabled small, interacting groups to perform significantly better than their most capable members on two cognitive conflict tasks (p < .05). The findings suggest that Group Decision Support Systems that integrate facilitation, social judgment analysis, and information technology should be used to improve the accuracy of group judgment.     

Immersion in altered experience: An investigation of the relationship between absorption and psychopathology

Understanding alterations in perceptual experiences as a component of the basic symptom structure of psychosis may improve early detection and the identification of subtle shifts that can precede symptom onset or exacerbation. We explored the phenomenological construct of absorption and psychotic experiences in both clinical (bipolar psychosis and schizophrenia spectrum) and non-clinical participants. Participants with psychosis endorsed significantly higher absorption compared to the non-clinical group. Absorption was positively correlated with all types of hallucinations and multiple types of delusions. The analysis yielded two distinct cluster groups that demarcated a distinction along the continuum of self-disturbance: on characterized by attenuated ego boundaries and the other stable ego boundaries. The study suggests that absorption is a potentially important but under-researched component of psychosis that overlaps with, but is not identical to the more heavily theorized constructs of aberrant salience and hyperreflexivity.     

Group Therapy with Individuals and Families Coping with Illness or Disability in Israel

This paper illustrates a group intervention with individuals and family caregivers coping with illness/disability, and focuses on the relationship between the process of group development and the process of coping with the illness/disability. People experiencing illness/disability cope with a great deal of pressure and stress that stem from the illness's biopsychosocial demands. A group can provide encouragement and support and reduce helplessness, isolation, and despair through cooperation and use of mutual resources. The design of the intervention was based on our clinical experience with numerous groups for ill/disabled individuals or their family. The process is described and analyzed using examples from three documented groups, and is presented in terms of four variables: group process, group atmosphere, group content, and group intervention.     

The Quality of Group Decisions,Group Verbal Behavior,and Intervention

Individuals bring beliefs and knowledge to group meetings. Group decisions arise out of the exchange of these beliefs and knowledge. Because group interactions are mainly verbal, group verbal behavior should play a central role in determining the quality of group decisions, and process interventions should change group verbal behavior. Subjects were 168 new employees in a Japanese drug company, who constituted 42 four-person groups. Treatment groups received the Consensual Conflict Resolution (CCR) intervention that emphasizes a knowledge-based logical discussion and consensual resolution of conflicts. The group task was the NASA Moon Survival problem. It was found that (1) the quality of group decisions increases to the extent that group members exchange facts and reasons (defined as a "reasoning" orientation of group verbal behavior) and decreases to the extent that group members stick to their positions (defined as a "positional" orientation), and (2) the CCR intervention increases the reasoning orientation and decreases the positional orientation, thereby improving the quality of group decisions.     

Group reactions to dishonesty

Groups and individuals were compared for their willingness to incur financial costs in order to punish dishonest behavior by others. Study 1 demonstrated that dishonesty was punished more often by groups than by individuals and that groups’ higher willingness to punish dishonesty was mediated by stronger negative affect. Study 2 provided evidence that the increase in negative affect in groups was driven by exposure to other group members’ negative feelings and opinions during group discussions. Overall, the results suggest that being part of a group increases negative emotions toward dishonest others and leads to a greater willingness to engage in costly punishment.     

Group Leader-Recorder Relationship in a State Hospital: A Learning Tool

The process group for staff and trainees in institutional settings has become increasingly unpopular as a resource, although ironically, the need for such a group has grown. The author presents the idea that the process group is not used more often because of a general lack of understanding of the nature of such groups as well as a failure to clearly distinguish process groups from traditional psychotherapy groups. The author goes on to give a clear definition of the task and the boundaries of a process group and, using knowledge of systems thinking, discusses special techniques for running such groups with illustrative examples.     

Beyond Support: Group Psychotherapy with Low-Income Mothers

A review of the functioning of a group for low-income mothers during a 3-year period suggests that a positive therapeutic outcome can be achieved in spite of unorthodox group structural configurations and processes. General psychosocial characteristics of the target population are delineated, and techniques are described which are intended to enable members to participate and benefit from a group experience which includes significant exploration of interpsychic material. Case illustrations are offered of psychodynamic formulations and process interventions. Group leadership is examined, and it is suggested that a flexible, active, and autonomous stance on the part of leaders is a significant variable in achieving a positive group outcome.     

The Rank-Order Effect in Group Decision Making

Many studies indicate that group discussion candisproportionately reflect information known by all group members,at the expense of information known to only one group member, andthis is associated with suboptimal group decisions (Stasser &Titus, 1985). The present study examined the impact of threeprocedural factors on information sharing and quality of groupdecision: (a) group decision procedure (an instruction to "rankorder the alternatives" vs "choose the best alternative"), (b)information access during group discussion (reliance on memory vscomplete access), and (c) communication technology (computer vsface to face). Three-person groups worked on an investment decisionthat was structured as a hidden-profile task where criticalinformation was distributed unevenly prior to group discussion. Thedata provided support for a rank-order effect: Groups instructedto rank order the alternatives, compared to groups instructed tochoose the best alternative, were more likely to fully consider allof the alternatives, exchange information about unpopularalternatives, and make the best decision. But these effects onlyoccurred in face-to-face groups. In computer-mediated groups, therewas general information suppression and no effect of group decisionprocedure. Access to information during group discussion increaseddiscussion of both unique and common information, in theface-to-face conditions, but had no effect on group decisionquality. Taken together, the data suggest that procedural aspectsof group discussion may help overcome the impact of prediscussionpreferences on information processes and group decision.