Researcher and clinician: Role conflict and resolution

Group therapy investigations are often conducted by researchers rather than by experienced clinicians who also possess research expertise. Given the fact that doctorally prepared clinicians must demonstrate research competence in their education programs, it is surprising that there is not more research on group therapy. The literature indicates that research and group psychotherapy practice are considered quite separate entities. However, there is much that both processes have in common. The principal investigator's experience during a group psychotherapy research project suggested that the conflict between the roles of researcher and clinician may not be due to differences in the external processes but rather to difficulties in trying to combine them within one person. The value of the researcher-clinician is elaborated, and recommendations are offered.This paper was supported by a grant from the Group Psychotherapy Foundation.     

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.     

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.     

团体心理治疗中凝聚力的概念及测量研究述评

团体心理治疗中的凝聚力最初多被定义为人际信任、吸引和卷入,随着研究的深入,凝聚力的概念逐渐向多维的方向发展。对凝聚力的测量主要有MacKenzie的团体氛围量表、Lese等的治疗因素-凝聚力分量表及Piper的凝聚力量表等。目前团体心理治疗领域的研究对凝聚力的认识缺乏一致性。从凝聚力的概念建构着手,探索团体心理治疗过程,开发评估工具,构建系统的理论和模型,是值得国内研究者关注的方向。     

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.     

Psychotherapy research: an interplay between inner and outer and a succession of meanings

Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual’s experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the ‘Centre for research on the psychodynamics of personality’. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re‐authoring one’s life narrative is accepted as part of a productive therapy as well as discovering one’s inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.     

The ethical group psychotherapist: a coda

This concluding article of a two-part special section on the ethical group psychotherapist are highlighted: (1) the importance of the cultivation of the skill and knowledge base of the group psychotherapist in terms of pertinent legal statutes and ethical guidelines; (2) the criticalness of certain personality features related to the concept of virtue; (3) a therapist's self-awareness contributes to the capacities to think and respond ethically; (4) ethical decision making is most likely to occur when the group psychotherapist attends comprehensively to all dimensions that define the setting in which a dilemma emerges; and (5) that in the service of positive ethics, attention to the ethical dimensions of group psychotherapy practice should be continuously present. In agreement with other contributions to this section, I conclude that the commitment to the ethical practice of group psychotherapy must be made not only by the individual practitioner but also by educational and training programs and professional organizations.     

个体心理治疗的复杂性

本文尝试从复杂适应系统理论的角度对个体心理治疗的复杂性加以阐述。依据复杂适应系统理论,心理紊乱并不必然是心理健康的敌人;在个体心理治疗的动力发展过程中,治疗师与来访者相互适应突现配对联盟,来访者的心理变化或新的心理结构的突现具有不可预测性;心理治疗的目标是使得僵化有序、封闭、适应不良的系统朝向日益复杂、开放、灵活适应的状态转化。复杂适应系统理论为探索人类的心理体验与发展提供了新的思路和方法。     

People in groups: Dynamic and therapeutic aspects

The author differentiates between a sociological-interactional (horizontal) axis and a psychological-motivational (vertical) axis in the group, and discusses the socio- and psychodynamics both of and in the group from each of these points of view. In group therapy, five phases are described: 1) exploratory contact; 2) regression; 3) catharsis; 4) insight; and 5) social learning. Group psychotherapy with large diagnostically heterogeneous groups in a hospital setting, small diagnostically homogeneous groups, and group discussions with patients' relatives are all described. In addition, attention is paid to experiential psychodynamic group process groups (analytic self-experience groups), which provide young psychotherapists with the opportunity to gain insight into both groups and the psychodynamics stimulated within this framework. The training of group therapists should include, after academic studies, clinical experience, individual psychotherapeutic training, an experiential group, cotherapy, group therapeutic work under expert supervision, and theoretical training.     

Individual differences in chess expertise: a psychometric investigation

Starting from controversies over the role of general individual characteristics (especially intelligence) for the attainment of expert performance levels, a comprehensive psychometric investigation of individual differences in chess expertise is presented. A sample of 90 adult tournament chess players of varying playing strengths (1311-2387 ELO) was screened with tests on intelligence and personality variables; in addition, experience in chess play, tournament participation, and practice activities were assessed. Correlation and regression analyses revealed a clear-cut moderate relationship between general (and in particular numerical) intelligence and the participants' playing strengths, suggesting that expert chess play does not stand in isolation from superior mental abilities. The strongest predictor of the attained expertise level, however, was the participants' chess experience which highlights the relevance of long-term engagement for the development of expertise. Among all analysed personality dimensions, only domain-specific performance motivation and emotion expression control incrementally contributed to the prediction of playing strength. In total, measures of chess experience, current tournament activity, intelligence, and personality accounted for about 55% of variance in chess expertise. The present results suggest that individual differences in chess expertise are multifaceted and cannot be reduced to differences in domain experience.     

The baby and the bathwater: 'Professionalisation' in psychotherapy and counselling

The current rush to professionalisation in the field of counselling and psychotherapy, and some of its deleterious effects, are examined. The parallels between this process and the experience of psychoanalysis in the USA in the 1940s and early 1950s are demonstrated, quoting from contemporary critics; and comparisons are drawn with the American phenomenon of managed care. An account is offered of what is happening in terms of the sociology of professions, suggesting that 'expert systems' are being substituted for 'local knowledges—skills and wisdoms which cannot be fully systematised. The argument that this process is for 'the good of the client' is considered and rejected. Finally, some thoughts are presented about the likely future for counselling and psychotherapy, arguing that the victory of professionalisation and expertise is unlikely to be complete.     

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.     

Theory‐building case studies of counselling and psychotherapy

In addition to their potential for healing, psychotherapy and counselling offer extraordinary opportunities to observe human experience and behaviour. I suggest practitioners have expertise in and daily access to the phenomena that theories of counselling and psychotherapy seek to explain. Practitioners’ clinical experience can be accumulated and shared through theory-building case study research. This article summarizes the logic of theory‐building case studies and offers practical suggestions for conducting case study research.     

Concurrent individual and individual-in-a-group psychoanalytic psychotherapy

This paper's thesis is that concurrent individual-in-a-group and individual psychoanalytic psychotherapy can be conducted in conformance with psychoanalytic principles of treatment as well as can individual psychoanalytic psychotherapy alone. American psychoanalysts have shown little interest in group psychotherapy, probably because of earlier criticism that transference is diluted by the greater reality of the therapist in group psychotherapy. This is a misconception extrapolated from the mirror model of dyadic analytic technique. The criticism was formulated during a period when that model was prominent and there was little awareness that the actual personal relationship between patient and analyst played an important facilitating role in the dyadic analytic process, including providing a basis for investiture of transference. Also, the criticism was based on one-session-per-week group psychotherapy, whereas concurrent individual-in-a-group and individual psychoanalytic psychotherapy utilizes two group sessions plus one or two individual sessions per week, enabling a more intensive patient-therapist relationship. Concurrent group and individual psychoanalytic psychotherapy constitutes a contribution to the widening scope of application of psychoanalytic treatment.     

Confidentiality and privileged communication in group psychotherapy

The concept of confidentiality is fundamental to all forms of psychotherapy. The idea of protecting confidential material goes as far back as the Hippocratic Oath in ancient Greek history. Centuries later, authors continue to assert that "only by maintaining confidentiality can the essential groundwork of trust in treatment be developed" (Hough, 1992, p. 106). Others have even argued that without confidentiality, psychotherapy has no value (Epstein, Steingarten, Weinstein, & Nashel, 1977). Confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy and there are numerous people hearing the disclosures. Confidentiality in group therapy, once ignored in the literature on ethics, is gaining more attention as this modality becomes more widely practiced; so too is an acknowledgement that ethical dilemmas surrounding confidentiality in groups are commonplace. This article discusses the major considerations and dilemmas on confidentiality in group psychotherapy. We first review confidentiality broadly and discuss the ethical principles that are related to confidentiality. In the next section, we discuss the complexities of confidentiality in group psychotherapy. Finally, we review research on confidentiality in groups and describe common ethical dilemmas.     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

The (In)visibility of Psychodiagnosticians' Expertise

This study investigates decision making in mental health care. Specifically, it compares the diagnostic decision outcomes (i.e., the quality of diagnoses) and the diagnostic decision process (i.e., pre‐decisional information acquisition patterns) of novice and experienced clinical psychologists. Participants' eye movements were recorded while they completed diagnostic tasks, classifying mental disorders. In line with previous research, our findings indicate that diagnosticians' performance is not related to their clinical experience. Eye‐tracking data provide corroborative evidence for this result from the process perspective: experience does not predict changes in cue inspection patterns. For future research into expertise in this domain, it is advisable to track individual differences between clinicians rather than study differences on the group level. Copyright © 2015 John Wiley & Sons, Ltd.