Narrative of “Here-and-Now”: Cancer Survivors in a Group Psychotherapy Using SCT® (Systems-Centered Therapy)1,2

This study focused on “here-and-now” narrative and examined the process of group psychotherapy for cancer survivors using systems-centered therapy (SCT). In contemporary society, cancer survivors have a vital need for psychological support, and group psychotherapy and peer support are used as part of this need. In most of these interventions, participants are encouraged to speak freely and share their experience of cancer. This generally means speaking about “there-and-then” experience. It has been argued that one reason that narrative therapy produces a psychological effect is that the meaning of an experience changes when the experience is spoken about. SCT differs significantly from other group interventions in that it requires participants to talk about their here-and-now experience through the format of SCT's “functional subgrouping.” Functional subgrouping requires participants to listen, reflect, and build on similarities in their experience. In this study, we qualitatively examined how participants' experiences unfolded in the SCT group by directly addressing the group process. The study findings revealed that even though the participants did not directly share their cancer experiences in the group, they experienced an inexplicable sense of connectedness that had a positive psychological effect on them. They also experienced deep emotions through talking while using the SCT narrative style. In the process, the effects of the SCT narrative were discussed.     

Superiority and Social Interest by Alfred Adler

This paper examines the advantages of a particular way of supervising psychotherapy, namely, in a group setting with a special focus on the supervisee's countertransference experience. Group supervision is conceptualized as much more than presenting a case and getting feedback. Rather, the group is used in all its interactive complexity as it resonates in a myriad of ways to aspects of the case being presented. Furthermore, because of the complexity of conscious and unconscious interactions and reverberations during this process, it is often helpful to have a focus in the supervision. One helpful possibility is to center on the supervisee's countertransference experience and use the group to reflect, amplify, and process that experience. This can be a highly valuable way of helping the therapists increase their understanding of the case and enhance the quality of therapeutic interventions.     

The Tempo of Verbal Interaction in an Open Therapy Group Conducted in Rotation by Three Different Therapists

This article examines the experience of new members joining an ongoing psychotherapy group. The group's stage of development and the new member's personality development are suggested to be important variables in this significant event. The experience of joining is found to share some things in common with the beginning phase of group for the group as a whole, but also noted are some unique elements. The process of joining is viewed as a highly anxious event for the new member, with antecedents in the individual's life experience. The new member is compromised by not knowing the group members, nor their shared history, norms, and dynamics. Concurrently, the group may experience a range of fears, wishes, and anxieties about the new member. Developmental considerations for the new member and the stage of group help to inform intervention strategies.     

Narrating the Unsayable: Enactment,Repair, and Creative Multiplicity in Group Psychotherapy

This article introduces an approach to group analysis that places dissociation of traumatic experience at the center of group interaction. Healing in group is regarded as hinging on the enactment of unformulated and dissociated experience and affect. Enactments are regarded as involving the members of the group, the group as a whole, and the group analyst. Clinical examples are offered to illustrate the enactment of dissociated trauma that was unable to be suffered earlier and the enactment of absence and neglect that is non-represented. In this hermeneutic conception, the group comes to narrate what has happened but never been experienced, and healing accrues through the group’s witnessing and making affectively real what was hitherto unsayable and unthinkable. The group analyst uses and shares his or her own experience to facilitate this process.     

The Developmental Path to Expertise in Group Psychotherapy

This paper describes a trajectory by which an individual achieves expertise in group psychotherapy. Five developmental stages are posited. In the decisional-anticipatory stage, interest is developed in group psychotherapy. In the trainee stage, the individual masters the knowledge base of group psychotherapy and obtains fledgling experiences in a group. In the novice stage, the individual obtains additional experience in running groups and becomes socialized into a community of group psychotherapists. In the proficiency stage, the individual narrows his or her group psychotherapy focus and obtains more specialized experience in that area. At this time, supervisory and consultation skills are often developed. In the final stage of expertise, the expert must engage in a process of recognizing its limits and must devise ways to maintain it. Research that focuses on one aspect of expertise, level of experience, is reviewed. Three dimensions of difference are identified: (a) complexity of conceptualization of members and interventions; (b) fostering openness and engagement; and (c) focusing on process.     

Intentional and identity processes: A social constructionist investigation using student journals

In contrast to traditional theories of career development that focus on decision-making processes in relation to market work, [Richardson, M. S. (2004). The emergence of new intentions in subjective experience: A social/personal constructionist and relational understanding. Journal of Vocational Behavior, 64, 485-498], informed by social constructionism and considering both work and relationships, suggests that the process of emerging intentional states or intentional process is central to the broader task of constructing a life. This study was designed to investigate this process. The research situation consisted of three structured group discussions with students in a graduate class. Journals written after the group discussions constituted the data for the study. Based on the first stage of data analysis, the scope of investigation was expanded to include emerging identity states or identity process and the emotional experience of the group discussions. In the second phase of data analysis, intentional process and identity process data were analyzed for themes and the emotional experience data were coded. Results of both phases of data analysis are discussed in relation to future research and implications for practice.     

Symbolization of experience in the process of group development

This paper applies some of the concepts of the theory of experiencing (as developed within the client-centered school of thought) to psychotherapy process in the small group. The ideas of Rogers and Gendlin regarding how change occurs in psychotherapy are applied to the process of development in the group-as-a-whole. The role of perception and symbolization of experience in the process of group development is examined. A case example from group psychotherapy is used to illustrate the process of formation, the change of shared perceptions among the group members, and the importance of these perceptions to the functioning of the group.     

Joining group psychotherapy: developmental considerations.

This article examines the experience of new members joining an ongoing psychotherapy group. The group's stage of development and the new member's personality development are suggested to be important variables in this significant event. The experience of joining is found to share some things in common with the beginning phase of group for the group as a whole, but also noted are some unique elements. The process of joining is viewed as a highly anxious event for the new member, with antecedents in the individual's life experience. The new member is compromised by not knowing the group members, nor their shared history, norms, and dynamics. Concurrently, the group may experience a range of fears, wishes, and anxieties about the new member. Developmental considerations for the new member and the stage of group help to inform intervention strategies.     

Crisis Theory and Therapeutic Change in Small Groups: Some Implications for Community Mental Health Programs

Abstract

The role of sibling dynamics in group psychotherapy has received relatively little attention in the literature. Our clinical experience suggests that sibling issues regularly arise in the practice of group psychotherapy. This article provides an integrative view of sibling relationships from a family systems and self psychology orientation to group therapy. Special emphasis is placed on developmental and cultural differences as they affect sibling dynamics and the group leader’s role. A number of case examples are offered to illustrate ways to view clinical challenges in a manner consistent with the influence of sibling relationships on group members and group process.     

The effects of therapist turnover in a training clinic: The core group phenomenon

Group psychotherapy conducted in training settings presents the membership with a unique opportunity to experience and work through loss. This paper describes the potentially problematic influence of predictable therapist turnover in these clinical settings. The core group phenomenon which emerges as a function of this anticipatory grief is described, as are the dynamics of core group members who are particularly vulnerable to the comings and goings of therapists in training. Finally, the importance of therapist attention to the impact of the turnover process in group psychotherapy training programs is underscored.     

Towards emotional containment for staff and patients: developing a Work Discussion group for play specialists in a paediatric ward

This paper describes the evolution of a staff Work Discussion group run by a child psychotherapist in a teaching hospital for more than 15 years. It offers insight into the emotional experience of both NHS staff and patients as seen through the lens of the discussion of the staff’s work. The author identifies three main stages in the evolution of this group, as trust and the feeling of a safe space gradually developed. The first stage was identifying and understanding the emotional experience of patients, through the use of observational skills and psychoanalytic concepts; the second emerged as staff began to include their own emotional experience in the narrative; the last stage saw a qualitative shift in the staff’s capacity to share the pain generated by the work, knowing about it through holding it in the group’s mind and being able to reflect on it, allowing them to process experience in a way that made the work more bearable – akin to Bion’s concept of ‘containment’. This evolution is illustrated with relevant vignettes in the light of some theoretical and historical considerations. The paper demonstrates the value of Work Discussion groups in terms of indirectly supporting hospitalised patients, as well as promoting staff’s resilience and professional capacities in difficult contexts.     

I feel our pain: Antecedents and consequences of emotional self-stereotyping

According to Intergroup Emotions Theory people categorized as group members experience the emotions of their ingroup as a consequence of that membership. Four experiments showed that participants converged toward what they believed to be their specific ingroup’s distinct emotional experience when reporting emotions as group members, but not when reporting emotions as individuals. Such self-stereotyping of ingroup emotions occurred for an experimentally fabricated ingroup as well as a range of naturally occurring groups. Demonstrating the roots of this process in categorization, self-stereotyping was increased when motivations to affiliate were amplified and was moderated by ingroup identification. The adoption of ingroup emotions changed participants’ cognitive processing in a predictable way, demonstrating that emotional self-stereotyping involved the experience rather than merely the expression of group-based emotions. Self-stereotyping of ingroup emotions is thus one mechanism by which group-based emotions are shared and can be changed.     

Psychotherapy Training Process as a Group Experience: A Hermeneutic-Constructivist Perspective

This article focuses on the training of hermeneutic constructivist psychotherapists and aims to point out those aspects that make the group such a privileged place for the construction of the professional role. It hypothesized that the group, as a closed and transitory context, can promote an openness to the exploration of different alternatives and the experimentation of the professional role. The article concentrates especially on applying the psychotherapy group theory of G. A. Kelly to the group training of hermeneutic constructivist psychotherapists, describing this process through the experience cycle (Kelly, 1995) in the perspective of a transformative experience. Starting from the basic theories behind the therapeutic process, illustration will follow of the training procedure formulated to allow working with the group within a context of relationships that favor learning and experimentation of new roles. The various phases of group therapeutic training will then be illustrated. These have been formulated to enable working within the group in a relational context that favors the role of therapist construction, coming from the elaboration of certain areas of the personal system and from experimentation and the elaboration of this new role itself.     

Group process: A developmental view

Group process is a phenomenon which is still only partly understood. This paper investigates different factors which might contribute to group process and possible group developmental sequences. Theoretical ideas are illustrated in the context of a two-day therapeutic group experience.     

The Edge of Chaos: Enactment,Disruption, and Emergence in Group Psychotherapy

The author outlines his approach to the theory and practice of group psychotherapy. The emphasis is on therapy by the group rather than therapy in the group. The therapist's task is to help the group itself become the agent of change. The group is conceived as being composed of many multiple selves. The process of group psychotherapy unfolds through enactments that involve the whole group and the group therapist entering into the grip of repetitive and unmentalized self-states. These enactments are resolved when the group members, with the therapist's help and containment, can access alternative self-states that allow for new and unformulated experience to emerge. This dialectical movement between the rigid “familiar chaos” of enactment and the reflective and related working through is compared to the dynamic systems theory articulation of the tension between rigidity and chaos captured by Kauffman's notion that “life exists at the edge of chaos.” A group session is described that involves a painful enactment. It illustrates how the therapist allows the enactment to unfold by holding and containing intense affect and how the group members are helped to find their own meaning and new experience in interaction with each other.     

Moral injury,coherence, and spiritual repair

In the PTSD literature, moral injury represents dissonance between a person’s beliefs about how they and the world should function, and the trauma event(s) they experienced. Given the association of moral injury with the assumptive world, it is not surprising the concept is closely intertwined with spiritual concerns. This paper reports on a spiritually integrated group intervention designed to help veterans with PTSD in the process of moral and spiritual repair. Qualitative findings are shared from interviews conducted with 18 participants who completed the intervention. Themes are centred around participants’ overall response to their experience in the group; where they are at regarding feelings such as guilt, shame, anger, trust, sense of betrayal, and desire for forgiveness; changes in religious/spiritual beliefs and practices and the experience of moral injury; and if they now find meaning in the trauma. The findings support the need for additional treatment options that address the moral and spiritual aspects of trauma.     

Group Treatment of the Mother-Daughter Relationship

This article explores the analytic therapy group as a spiritual community that can deepen the implications of group transference. From this perspective, group-as-a-whole dynamics include a spiritual dimension in addition to the recapitulation of the family of origin. Clinical vignettes are introduced from a midphase group to illustrate a means of working with spiritual and religious themes psychodynamically through managing them like dreams. Amplification and interpretation of the symbolic themes guide members through the transference to the family of origin. There, members gain access to childhood memories and to the childhood transitional space of religious experience where they created their God representations as a means of solving their self and object dilemmas. The working-through process facilitates the integration or transformation of new self and God images.     

Procedures for Identifying Persons with Potential for Public School Administrative Positions by William C. Schutz

This investigation is based on over 400 American Group Psychotherapy Association members involved in 41 intensive, two-day training experiences for mental health professionals. The participants completed a questionnaire immediately after their group sessions to evaluate the process and leadership variables that contributed to a constructive learning experience. A similar questionnaire was mailed to participants three to four months later to explore the impact of training on group interventions within their clinical practices. One third of the trainees responded to the follow-up survey. Overall, the findings suggest that successful outcomes are related to a range of group processes, such as self-disclosure, feedback, and interpersonal support, as well as personal qualities and technical expertise modeled by the leaders of the training groups. Both the immediate and delayed assessments demonstrate that the groups were regarded as highly valuable learning opportunities.     

Terminations

Whether the person leaving the group is a group member or a group therapist, the basic dynamics of separation are the same, involving the separation process as well as mourning. Terminations evoke ambivalent feelings of both separation-pain and hope. Group members and the departing person experience a loss, which reminds them of other losses, and the departing person (group member or therapist) may also experience some guilt. Any termination will have an effect on the-group-as-a-whole, as well as on the individual members, and must be dealt with prior to the actual leaving, as well as after the termination.     

Group therapy as an adjunct to medication in the management of bipolar affective disorder

This paper asserts that, contrary to the beliefs of many clinicians, patients with bipolar affective disorder often experience a deteriorating course characterized by pervasive social dysfunction. It reviews the literature, identifying a rationale for group psychotherapy as an adjunct to medication in the management of these chronic patients. It outlines a theoretical approach to bipolar group therapy, and presents a retrospective study comparing the course of 43 lithium-treated bipolar patients before and after entering bipolar groups. During the year in group therapy, bipolar patients displayed significant improvements in symptom relief as well as social functioning. It is proposed that group process enhances treatment with medication, providing benefits not evident with medication alone.