Inpatient adolescent group therapy as a social system

This paper describes a method of group therapy that 1) utilizes open systems theory to describe the social structure of group therapy, and 2)presents interventions drawn from Masterson's ideas for treating borderline personality disorders. Illustrations from a group therapy program for chemically dependent adolescents in a short-term, inpatient treatment unit of a general hospital are offered. It is proposed that under constrained conditions of treatment, such as those described, group therapy can be effective if there is precision about the system boundaries of task, role, time and place, and if group interventions are based upon a theoretically and clinically consistent model such as Masterson's.     

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.     

Hope in a strengths-based group activity for individuals with chronic pain

While hope has been described as the ability to imagine a future in which one wishes to participate, individuals with chronic pain can have difficulty maintaining hope due to the pervasive impact of pain on multiple facets of their lives. This research examines client experiences of hope during a hope and strengths activity offered as part of a group treatment plan for individuals experiencing chronic pain. Entitled Being Hopeful in the Face of Chronic Pain, the group was developed in order to focus on hope and generative emotional experiences, experiences often lacking for individuals with chronic pain. The group activity being studied specifically addressed participants’ current strengths and strengths they hope-to-have-more-of. The study employed basic qualitative inquiry and utilized interpersonal process recall individual interviews to stimulate participant recall. Twelve participants (spanning three separate group offerings) individually discussed their personal experiences as they unfolded during a specific hope and strengths-focused activity. Participants described experiences during the group activity that fostered personal hope via perspective shifts, communion, comparison and connection with other group members. Findings are discussed in the context of current literature on hope, chronic pain, positive psychology and group interventions.     

Screening for Psychotherapy by an Open-Ended Group

A developmental model of conducting a time-limited, short-term inpatient psychotherapy group is described. The therapist's primary goal in this model is to promote members' awareness of their dysfunctional interpersonal behaviors and the conflicts underlying these behaviors. The therapist pursues this goal by facilitating the group in resolving the conflicts of the four phases through which the group passes. In Phase I, the group addresses conflicts related to the establishment of trust. In Phase II, issues related to dependency wishes focused upon authority figures occupy the group's attention. In Phase III, conflicts within peer relation-ships become focal. In Phase IV as the group approaches termination, group members explore feelings related to the acceptance of loss. For each phase, optimal therapist interventions are described.     

The Bulimia Workshop: A Unique Integration of Group Treatment Approaches

The time constraints of weekly group therapy and the slow evolution of group cohesion attenuate the direct confrontation that is essential with bulimic patients. Consequently, a three-phase, multidimensional group program was devised to accelerate the treatment process. Treatment begins with an intensive weekend workshop during which members formulate contracts for interrupting the binge–purge cycle and changing symptomatic behavior. During a follow-up session problems in fulfilling the contracts are dealt with and successes are reinforced, in the final phase, group members convene without their therapists to provide peer support, reevaluate contracts, and share feelings regarding treatment progress. The unique implications for treatment process and therapist interventions prompted by this new format are discussed, and preliminary research findings are highlighted.     

Being transformed: Delivering a psychotherapeutic group intervention targeting repeat suicide attempts

Clients who make repeat suicide attempts have complex needs, are at high risk of completed suicide and pose a range of challenges for clinicians. Targeted interventions are required. Acceptability, the perceived appropriateness of an intervention, is associated with successful implementation, engagement and effectiveness of interventions. Despite the advantages of group interventions, there is limited research into the acceptability of groups with this population. Using Interpretative Phenomenological Analysis, this paper reports on facilitators’ experiences (n = 9) of the acceptability of a therapeutic group intervention (PISA – a Psychoeducational/psychosocial Intervention for persons who make recurrent Suicide Attempts). Analysis of focus group data revealed how involvement with the intervention profoundly influenced facilitators’ perceptions of and approach to their work with this client group. They embraced the model, developed a deeper appreciation of clients’ resources and became unburdened from sole responsibility for the clients, the therapeutic process and outcomes. PISA provided a model that helped facilitators to work in a focused, compassionate and creative manner as they addressed the central concern of these clients, their suicidal desire, with newly found confidence and eagerness. PISA was experienced as acceptable to facilitators as it was useful to them and deemed appropriate and beneficial to the target population.     

Self-recording and goal-setting: Effects on on-task and math productivity of low-achieving Korean elementary school students

Using an alternating treatments design, we investigated the effects of self-recording and goal-setting on the on-task behavior and the mathematics productivity of five low-achieving elementary school students in a group of eleven students in Korea. We also examined which intervention students preferred after they experienced self-recording and goal-setting. Visual analyses of the data showed (a) increases in students' on-task and mathematics productivity levels contingent upon the implementation of both self-recording and goal-setting, (b) no differential effects of the two interventions, and (c) students' general preference of goal-setting to self recording. We interpreted these results as indicating that both self-recording and goal-setting are effective self-management strategies, but practitioners must consider the features of the interventions before selecting one from them, and future researchers must examine the effect of combining the two procedures.     

The Greek Chorus and Other Techniques of Paradoxical Therapy

This paper has described some of the interventions developed at the Ackerman Brief Therapy Project in treating the families of symptomatic children. The interventions are based upon a differential diagnosis of the family system and upon an evaluation of that system's resistance to change. They are classified as compliance-based or defiance-based, depending upon the family's degree of anxiety, motivation, and resistance. Paradoxical interventions, which are defiance-based, are used as a clinical tool in dealing with resistance and circumventing the power struggle between therapist and family. A consultation group acting as a Greek chorus underlines the therapist's interventions and comments on the consequences of systemic change. This group is also sometimes used to form a therapeutic triangle among the family, therapist and group, with the therapist and group debating over the family's ability to change.     

An on site stress workshop for teachers: The creation of a therapeutic group environment

This paper describes an ongoing stress workshop conducted for 5 years in an elementary school. The school was located in an economically deprived area in the Bronx, New York. Similarities and differences between on-site workshops and therapy groups are discussed. The developmental stages of the group and its corresponding issues are analyzed in terms of group process, transference, and resistance. Illustrative vignettes are presented. The positive effects of group dynamic and group therapy interventions on the participating group as well as on nongroup personnel is demonstrated. Suggestions for adapting group therapy methods in school settings are also presented.This paper was presented as a poster at the Annual Conference of the American Group Psychotherapy Association held in Atlanta, Georgia, February 1995.     

Group therapy with dual-diagnosed adolescents

This paper presents an eclectic orientation to group therapy, which guides the authors' clinical work with adolescents diagnosed as both mentally ill and mentally handicapped. Highlighted are the treatment needs and the difficulties working with this population, theories of group process and their implication for treatment, and specific clinical techniques that foster individual and group growth. Specificallly, this paper outlines the clinical rationale and group interventions used in a process-oriented group for dual-diagnosed adolescents residing in a residential setting. This group is designed to develop the clients' interpersonal understanding and skills, which will hopefully enhance their overall adaptation and functioning in the residential milieu. It is believed that the integration of a variety of theoretical approaches is critical for group therapy with this population.He was Senior Cottage Therapist or Unit Director at the William Roper Hull Child and Family Services, Calgary, Alberta, while doing group work with dualdiagnosed adolescents.He was a Cottage Therapist at Hull Child and Family Services, while doing the group work cited in this pape     

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.     

Schools of Psychoanalytic Thought by Ruth L. Munroe

This paper assesses the impact of large-group processes and dynamics upon the patient-staff community meeting in hospital treatment. It focuses upon the therapeutic values and limitations of the large-group format by examining, from an integrated general systems and object relations perspective, how size, structure, patient population, staff training, and leadership variables reciprocally affect the process and content of the community meeting. The special problems associated with selecting an appropriate format for the meeting and the intense pull of regressive group forces upon the large-group leader are discussed.     

The Treatment Acceptability/Adherence Scale: Moving Beyond the Assessment of Treatment Effectiveness

It is becoming more broadly recognized that beyond effectiveness, the acceptability of interventions for anxiety disorders is an important consideration for evidence-based practice. Although advances in treatments for anxious psychopathologies have demonstrated that cognitive-behavioural interventions are more desirable than other types of psychotherapy or pharmacotherapy, there continue to be problems with adherence and dropout. It has been suggested that low treatment acceptability may be partially responsible for high dropout rates. Although a number of preliminary investigations in this domain have been conducted, further progress is hampered by the absence of a single self-report measure that assesses both acceptability and anticipated adherence. Therefore, the current paper aimed to test the psychometric properties of the newly developed Treatment Acceptability/Adherence Scale (TAAS). In two studies of brief cognitive-behavioural interventions, the TAAS was administered immediately following the therapy session. In Study 1 (N = 120 non-clinical undergraduates), the therapy included two variants of an exposure-based intervention for contamination fear. In Study 2 (N = 27 individuals with obsessive-compulsive disorder), the therapy was a cognitively based intervention evaluating a novel treatment technique for checking compulsions. Measures of convergent and divergent validity were included. Results demonstrated that the TAAS exhibited sound psychometric properties across the two samples. It is hoped that this measure will help clinicians to predict and intervene when a treatment is not acceptable and/or when the client anticipates poor adherence to it. Furthermore, the TAAS may aid researchers in continuing to improve upon effective interventions for anxiety and related disorders.     

Dimensions of counselor functioning

In 1957 the editor of the Journal of Counseling Psychology rejected an article on group counseling because, by definition, “Counseling is a process in which two persons….” Since then the functions of a counselor have broadened to include working with groups in many ways. Some will maintain that we have expanded far beyond our domain into that of the organizational psychologist. The authors of this article assume that the counselor's functions should include a wide range of interventions and have organized them within a “Cube.” This model provided the structure for this Special Issue. The three dimensions of the Cube are: (a) the target of the intervention, (b) the purpose of the intervention, and(c) the method of intervention. We think this model has great heuristic potential as a tool for both research and practice.     

Translating the Restoring Body Image After Cancer (ReBIC) Group Therapy Intervention Into an Online Version: A Successful Case Study and Recommendations

ABSTRACT

A growing number of face-to-face group therapy interventions are being translated into online versions in psycho-oncology. Yet few researchers have systematically described the complex translation process or systematic approaches used to maintain the integrity of the original empirically supported interventions. In this article, we present a case study to illustrate the process of translating an evidence-based face-to-face therapy group, Restoring Body Image after Cancer (ReBIC) into an online format. We highlight how three critical therapeutic components from the original intervention (guided imagery exercises, psychoeducational reading materials, and psychotherapeutic group processes) were maintained and translated for online delivery. We provide preliminary recommendations for future translation efforts of text-based online group therapies to encourage best practices.     

Effects of guided immune-imagery: The moderating influence of openness to experience

It is widely believed that personality has an important role in determining the effectiveness of guided imagery (GI) interventions. The primary aim of the current study was to examine whether the effect of GI on several outcome measures was dependent upon openness to experience, a theoretically relevant variable previously unexplored as a potential moderator. Thirty-five healthy participants were randomised to an animated imagery, verbal imagery or no-intervention control group, with imagery groups receiving 10 × 20 min sessions. Pre/post-assessments of cortisol, sleep, stress and creativity were administered along with the openness to experience scale. Regression analysis indicated a significant increase in cortisol and decrease in tiredness following verbal GI, but only for those high in openness. The efficacy of GI interventions may be dependent upon openness to experience and this variable should be accounted for in future studies.     

Cost-effectiveness of online positive psychology: Randomized controlled trial

As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a randomized controlled trial of an online positive psychological intervention, a health-economic evaluation was conducted. Mild to moderately depressed adults seeking self-help and recruited in the general population were randomly assigned to the intervention group (n?=?143) and a waitlisted usual care group (n?=?141). Improved clinical outcomes were achieved in the intervention group (at least for depression) at higher costs. When outliers (the top 2.5%, n?=?5 in intervention group, n?=?2 in control group) were removed, cost-effectiveness was increased considerably. For positive psychology, economic evaluations may be a means to nudge policy decision-makers towards placing positive psychological interventions on the health agenda.     

Comparing different boosters of planning interventions on changes in fat consumption in overweight and obese individuals: A randomized controlled trial

Single planning interventions have been found to promote short‐term dietary change. Repeated planning interventions may foster long‐term effects on behavior change. It remains unknown whether there is a critical number of boosters to establish long‐term maintenance of behavioral changes. This study aimed at investigating what social‐cognitive variables mediate the effects of the interventions on dietary behavior change. Overall, 373 participants (n = 270 women, 72.4%; age M = 52.42, SD = 12.79) were randomly allocated to one of five groups: a control group, a single planning group, and three groups with 3, 6, or 9 weeks’ repeated planning interventions. Follow‐ups took place 4, 6, and 12 months after baseline. Change in fat consumption was not promoted by any of the interventions. In terms of social‐cognitive variables, intentions, self‐efficacy and coping planning displayed a time × group interaction, with the 9 weeks’ planning group showing the most beneficial effects. Effect sizes, however, were very small. None of the tested planning interventions successfully promoted change in fat consumption across the 12 month period. This, however, could not be explained by problems with adherence to the intervention protocol. Potential explanations for this unexpected result are discussed.     

Dreams,Memories, Reflections by C. G. Jung

Abstract

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders.

Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.     

The role and importance of interpretation in the talking cure

Starting with an exploration of how the concept of interpretation in analytical treatment has evolved, the author goes on to discuss the role and importance of interpretation in the changes that psychoanalysis brings about. Although interpretation is looked upon as the key element in psychoanalytic activity, the fact that it is subsumed within the transference raises questions as to its influence in the analytical domain. After discussing the foundations of interpretation with respect to the theory of psychoanalytic treatment and examining Strachey’s views on this, the author defines the conditions and constraints surrounding interpretation and preparatory interventions in order to outline the essential nature of the interpretative process as seen against the wider background of the analyst’s activity as manifested through speech. This leads to a discussion of the relative influence of insight and suggestion in bringing about therapeutic change. The author draws the conclusion that interpretation works as a metaphor in lifting repression.