Inherent moral practice in group psychotherapy

The large amount and variety of group psychotherapy practiced today enjoins us to determine its morality, that is, its rightness or wrongness. In this essay group therapy and morality are briefly defined. Using the writings of both philosophers and psychologists, evidence of morality is sought in the intentions and actions of both the patients and therapist and in the group process itself. Paying attention to "personal valuative acts," which are moral in nature and in outcome, group psychotherapy results in the good of the patient, of the therapist, and of the art or practice of group psychotherapy itself.     

Resolution of a drug abuse problem in a private practice setting

This case study involves a 27-year-old male who began therapy in an effort to understand his drug abuse. As an essential part of treatment, the client was asked to abstain from drugs. In doing so, he began to experience and understand the feelings of anxiety which drugs had defended him against.The therapeutic technique used provided for the therapist to establish an interaction with the client by playing the dual role of the supportive, yet assertive father and the soothing, yet separation-encouraging mother. Consequently, the client was able to experience, confront and work through his anxiety.     

An experiential group model for psychotherapy supervision

This article presents an experiential group model of supervision constructed for both group and individual therapy presentations, emphasizing concepts from object relations theory and group-as-a-whole dynamics. It focuses on intrapsychic, interpersonal, and systems processes, and stresses the group aspect of the supervisory process. Its central thesis is that material presented in a group supervisory setting stimulates conscious and unconscious parallel processes in group members. Through here-and-now responses, associations, and interactions among the supervisory members, countertransference issues that have eluded the presenter can make themselves known and be worked through on emotional as well as cognitive levels. Selected excerpts from supervisory sessions demonstrate various attributes and strengths of the model.     

Informed consent in the practice of group psychotherapy

Endorsed as part of ethical practice in group psychotherapy by professional organizations, informed consent is a process of communicating essential information about group treatment to patients so that they can make rational decisions about treatment-whether to enter and how to participate. Its benefits as well as necessary precautions are discussed. The design and implementation of the informed consent process for group is discussed in terms of who should obtain it, when it should occur, how it should be communicated, and what information should be considered for inclusion. Specific suggestions are included as well as a discussion of some potential ethical dilemmas.     

Change during and after long-term analytic group psychotherapy

There are very few empirical studies of long-term, analytic group psychotherapy. Sixty-nine patients in long-term analytic group psychotherapy were evaluated from pretherapy to posttherapy, and one year after termination. The primary outcome measures were the Symptom Checklist-90 (Revised) and the Inventory of Interpersonal Problems. In addition, the Global Assessment of Functioning (GAF) was scored independently by two evaluators. The average time in treatment was 32.5 months. The patients improved significantly during treatment, up to 30 months, on all measures. The improvement continued during the follow-up period. Sixty to 86% of the patients were recovered or significantly changed at follow-up.     

Brief crisis group psychotherapy versus the initial sessions of long-term group psychotherapy: An exploratory comparison

An attempt was made to specify the therapist behaviors characteristic of the brief crisis group (BCG) approach, to assess how patients experience BCG on dimensions of session impact and group climat, and to describe the changes possible from BCG on measures of outcome by contrasting this modality with the initial sessions of traditional long-term therapy groups in a preexperimental design. Data obtained from four eight-session BCGs and three beginning long-term groups (LTG) were used for analyses. Patients were administered the Session Evaluation (SEQ) and Group Climate (GCQ) Questionnaires at the end of each group session. Two judges sat in on each session and coded the types of therapist interventions using the Therapist Behavior Categories (TBC) system. Aspects of self-esteem and symptomatology were assessed as indices of change over the 8-week period in a pre-post fashion. Therapists in BCG evidenced a distinct pattern of interventions during midpoint group sessions (sessions 3–6), placing a greater emphasis on challenging patient perceptions and providing information than their LTG counterparts. The therapists' use of self as an issue in BCG increased as termination approached and apparently served a more limited function than in LTG. Patients in BCG reported a more rapid development of a working group and experienced greater session benefit. Patients in BCG also reported lower levels of conflict and avoidance and a greater decrease in these resistance behaviors. As expected, BCG patients reported substantially greater improvement on most outcome dimensions at the end of the 8-week period. Results are considered as clarifying the approach to and impact of BCG psychotherapy.An earlier version of this paper was presented at the 15th Annual Meeting of the Society for Psychotherapy Research, Lake Louise, Alberta, June 19–23, 1984.     

Insight-oriented group psychotherapy of latency-age children in an acute care setting

Traditional approaches to group therapy with latency-age children have stressed activity and nonverbal therapeutic interventions. These approaches originated in the 1940s with Slavson's activity aroup therapy. A review of the literature of the past 25 years reveals that many clinicians have increasingly employed verbal techniques with latencyage groups. Most such reports describe groups for latency-age out-patients. In this paper, a verbal, interpretive technique for group therapy with latency-age inpatients is described. Clinical vignettes are included to illustrate this technique. Our experience suggests that such a technique can become an integral part of the inpatient treatment program for the latency-age child.     

The contribution of feedback to outcome in long-term group psychotherapy

Two long-term analytic inpatient psychotherapy groups, comprised of severely disturbed neurotic and personality disordered patients, were intensively investigated using process ratings and therapist and patient reports to examine the contribution of interpersonal feedback to treatment outcome. We found that feedback was important throughout the course of therapy, and that patients who derived the most benefit from the groups were those who experienced a greater level of group cohesiveness and were most active in terms of self-disclosure, receipt of feedback, and making significant behavioral modifications within treatment. These successful patients received both positive and negative feedback, primarily from other group members, and worked effectively toward the goals that brought them to treatment.     

An integrated model of group psychotherapy for patients with fibromyalgia

This study examined the effectiveness of an integrated model of brief group psychotherapy for treatment of fibromyalgia syndrome, using cognitive behavioral and supportive expressive techniques. In the context of an outpatient, multidisciplinary fibromyalgia treatment program, group psychotherapy was provided to 35 patients with 21 control patients. Pre-post treatment measures of depression, anxiety, fibromyalgia impact, pain, fatigue, and morning tiredness were obtained. Using a quasi-experimental design with validated psychometric instruments, the results showed a significant decrease in pre-versus post treatment measures of depression, fibromyalgia impact, fatigue, and pain for the treatment patients, suggesting that an integrated model of group psychotherapy may have beneficial psychological and functional effects for some patients with fibromyalgia.