The group-as-a-whole approach in Foulksian group analytic psychotherapy

The group analytic group-as-a-whole approach of Foulkes privileges the concept of the group matrix. The term matrix is a metaphor for the network of all individual mental processes, the psychological medium in which they meet, communicate, and interact. The developing group matrix acts both as a container and as a holding environment for the psychic processes of the individual members in the group context. The concept of coherency is evoked to describe the process of the developing capacity of a group to be therapeutic. The concept of coherency is applied both to conscious and to unconscious mental process.     

Alliance to the group-as-a-whole as a predictor of outcome in psychodynamic group therapy

Abstract Eighteen patients diagnosed with burnout-related depression and receiving short-term psychodynamic group psychotherapy were included in this study. The participants completed the group version of the California Psychotherapy Alliance Scales (CALPAS) five times during treatment and evaluated the relationship positively. Alliance increased significantly as treatment progressed; however, the amount of change was small. Level of alliance to the group-as-a-whole, averaged over time, was predictive of two out of three outcome measures, whereas growth in alliance during the early phase of therapy was not predictive of outcome. Exploratory examination of the alliance at different time points showed that alliance to the group-as-a-whole at mid-phase of treatment was substantially correlated with outcome. Personality features such as dismissing attachment style and being overly nurturant or exploitable were predictive of early growth in alliance.     

Video self-portraits: a novel approach to group psychotherapy with young adults

A group therapy model was formulated for exploring the intersubjective processes of adolescents and young adults whose group bonds had been fragmented by their severe emotional illnesses. The model involved having adolescents and young adults who were psychiatric inpatients make video self-portraits; that is, videotapes which focused on various aspects of their emotional pathology. These tapes were then presented before a larger group of nine patients for discussion. The video team method is shown to aid in self-disclosure and facilitate the working through of severe emotional conflicts in this age group. It is an especially useful method with more severely disturbed patients for whom narcissistic self pathology is a prominent feature.     

Theory of the invisible group applied to individual and group-as-a-whole interpretations

The theory of the Invisible Group explains the dynamics of groups in terms of four separate systems, hierarchically and isomorphically related, which enable the therapist to view group from four different perspectives and to interpret four different dimensions of group process. Person and member interpretations apply to aspects of the individual system; group-role and group-as-a-whole interpretations apply to aspects of the group system. Clinical examples illustrate how the psychotherapist can modify the dynamics of the group at the individual or at the group-as-a-whole level by modifying interpretations.     

Cotherapy in psychodynamic group psychotherapy: An approach to training

Cotherapy in a training relationship with a senior therapist/supervisor and a trainee/junior leader is presented. A structured training year with planned sessions for the junior leader to lead the group alone, as well as intensive supervision, is described. The training relationship is seen as evolving into an egalitarian, collegial working relationship. An incidental benefit of this cotherapy approach is that additional opportunities are provided for group members to work through attitudes, feelings, and behaviors associated with attachment, interpersonal relationship (autonomy and affiliation), separation, and loss. Potential drawbacks and applications are also noted.The authors express their appreciation to the many group members and cotherapists whose experiences provided the stimulation and clinical material for the present formulation.     

Integrating group psychotherapy and 12-step work: a collaborative approach

Group therapists can expect to treat an increasing number of patients who are active in a 12-step program or other addiction-related self-help groups. The value of simultaneous participation in these two modalities has been recognized; 12-step work supports abstinence necessary for the focus on emotional growth in psychotherapy. However, mere simultaneous participation in the two modalities fails to incorporate the benefits of a collaborative relationship where both modalities are used to support both abstinence and emotional growth. The conjoint approach to group and individual treatment is used to (a) argue for the possibility of a collaborative relationship between psychotherapy and a patient's 12-step work, (b) understand the benefits and challenges to collaboration, and (c) provide guidelines for how to work collaboratively with a 12-step program. Illustrations are provided of typical issues raised by this type of collaborative relationship.     

A time-limited dynamic approach to adolescent inpatient group psychotherapy

In response to sharply curtailed lengths of stay of adolescents in an inpatient psychiatric program, new therapeutic modalities need to be implemented. A time-limited dynamic approach to adolescent inpatient group psychotherapy is presented. The model integrates psychoanalytic and crisis theory into a group format. The primary focus in this model is upon resolution of problematic interpersonal interactions as they are related to the current crisis state. The group process, as related to the adolescent, involves three phases. These include an initial intake phase, which incorporates an ego-functioning assessment; a second or middle phase which focuses on making actions ego-alien; and the termination phase, which incorporates the learning experience and how it relates to the resolution of precipitators of the admission.     

A dynamic/expressive approach to brief inpatient group psychotherapy

Therapeutic action occurs in groups when patients simultaneously become more accepting of their own thoughts and feelings and increase their capacity to share more benign and mature interpersonal relationships with the therapist and other patients. This orientation can guide practitioners of brief inpatient group psychotherapy in choosing when to use interpersonal, problemsolving, or object relations techniques, or more traditional dynamic/expressive techniques. While the brief inpatient modality requires an increase in suppressive techniques compared to the longterm outpatient modality, suppression must be used judiciously, to facilitate rather than interfere with selfunderstanding and development of therapeutic relationships. Specific technical choices are derived from this principle and illustrated with a case example.     

Conceptualising the family-friendly career: the contribution of career theories and a systems approach

Mainstream theories of career have been charged with a lack of 'critical, multidisciplinary, gendered, and contextualised work'. This suggests that they would not readily be able to encompass the notion of the family-friendly career. This paper contextualises their shortcomings, notes some responses to them over time, and identifies some recent theorising that seems more likely to be able to contribute to 'joined-up thinking' on career and family-friendly issues. It then proposes the value of a systems approach and soft systems thinking to conceptualising a (family-friendly) career, and introduces the concept of a 'family career'.     

Introduction to object relations group psychotherapy.

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or "basic assumptions group." Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

A multiple group psychotherapy approach to adolescents with psychiatric and substance abuse comorbidity.

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.