Consistency of Response to Personality Inventory Items as a Function of Length of Interval Between Test and Retest

Summary

Four member discussion groups (N = 80 male and female college students) were set up in which two members favored each side of the issue. In half the groups, the involvement of the members in the issue under discussion was relatively high; in the other half it was relatively low. While the potential for intragroup tension was greater in the high involvement group, this threat was successfully dealt with by a significantly larger number of tension reducing statements and statements deflecting hostility towards objects outside the group. These defensive maneuvers were particularly marked for one of the two discussion topics which appeared to be intrinsically more involving.     

Group psychotherapy as a technique for assisting ego-impaired children and adolescents

This paper describes an approach to working with egoimpaired children and adolescents. The structure and process of psychotherapy groups within a residential program are discussed. We describe how insight-oriented groups act as a collective superego, thereby encouraging maturation. Functions of the group relating to socialization, milieu issues, peer issues, family relationships, personal issues, selfesteem, empowerment, and special issues are discussed. The focus of the discussion is on the structure and process of the groups. Brief clinical vignettes are utilized to illustrate components of the approach.     

Process and content in a long-term PTSD therapy group for Vietnam veterans

Process and content were studied in four 16-session segments of a psychodynamically oriented therapy group for Vietnam veterans suffering from posttraumatic stress disorder (PTSD). On the Group Climate Questionnaire (GCQ-S), the group scored significantly higher in the Engaged dimension and significantly lower in the Avoiding and Conflict dimensions than contrasting samples of neurotic and psychotic groups. There was no evidence of group stages. Topics related to symptoms of PTSD were discussed most frequently (43.1%), followed by issues concerning relations with others (32.4%),general group therapy issues (13.7%), and other topics (10.8%). Clinical implications of these findings are discussed.The authors thank Tom Metzler, M.A., and Heidi Ronfeldt, B.S., for their assistance with the data analysis.Parts of this paper were presented at the American Group Psychotherapy Association Annual Meeting, February 15–20, 1993, San Diego, CA.     

The Class Method in the treatment of Psychotic Patients

Contrary to traditional thinking, a review of the recent literature has suggested that bipolar patients can be treated in homogeneous therapy groups in conjunction with concomitant lithium management. Important psychodynamic and interpersonal features are reviewed that have received empirical support and have enhanced our understanding of these patients. Goals for bipolar groups include educating patients on the nature of the disease, helping them learn ways of coping with its symptoms, and encouraging them to discuss relevant psychodynamic and interpersonal issues. To achieve these goals, therapists have used techniques involving education, support, and facilitation of group discussions. Further clinical and empirical work needs to be done to evaluate the effectiveness and process of these bipolar groups, particularly in the inpatient setting.     

Group Session Rating Scale: Preliminary psychometrics in substance abuse group interventions

Background: Although ultra‐brief outcome and process measures have been developed for individual therapy, currently there are no ultra‐brief alliance measures for group therapy. Method: The current study examined 105 clients in group therapy for issues related to substance abuse or with issues related to the substance abuse of a significant other. We tested whether a newly developed group therapy alliance measure – the Group Session Rating Scale would be related to other commonly used group process measures (Working Alliance Inventory, Group Cohesion, Group Climate) and early change (change over the first four sessions of group therapy). Results: The findings provided support for reliability based on Cronbach alphas and test‐retest coefficients. Additionally, the GSRS was a one‐factor measure that was related to other group process measures as well as predicted early change. Discussion: Clinical implications for how to utilise ultra‐brief outcome and alliance measures are provided.     

Bargaining strength and group polarization in intergroup negotiations

In the context of a labour-management simulation study, three-man union teams were made to believe that they had either a very strong or a very weak bargaining position vis-à-vis the other party. In half of each of these conditions, a cooperative and a competitive orientation toward the other group was induced. In preparation for the intergroup negotiations, the subjects were first asked to indicate their individual aspirations for three negotiation issues. After a group discussion, their collective aspirations were obtained. Regardless of the experimental conditions. groups set significantly higher aspiration levels than individuals on the most important issue but were more conservative and cautious on less important issues. In general, for all three topics, significant or near-significant interactions were found between bargaining strength and the direction of the group-induced shift. In the strong bargaining condition, groups set higher aspiration levels than the average of prior individual judgments; in the weak bargaining condition the opposite trend occurred. An effort was made to relate these findings to the various theories developed in the ‘risky-shift’ literature.     

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.     

School-based discussion groups for children of divorce: A pilot program

This paper describes a pilot program for school-based discussion groups for children of divorce. Relevant literature is reviewed and a model for a semistructured discussion group for latency-aged children is presented. Particular techniques used to engage children in discussion of relevant issues are described. While we have not conducted a systematic outcome study of these groups, our impression is that while some definite concrete changes have occurred for several children, for others, change has been located more in the representational than behavioral world. Children may remain unable to communicate angry feelings to the absent parent but as a result of the group experiences may be able to stop thinking of themselves as bad for harboring such feelings in the first place.Formerly an Elementary Guidance Counselor in the Brookline Public Schools, currently is an Educational Consultant in the Philadelphia area.     

“Bipolar groupthink”: Assessing groupthink tendencies in authentic work groups

Research on regressive group processes such as Janis’ (1982) “groupthink” phenomenon has rarely focused on work groups in authentic settings. In this study, teams from six different organisations (n=308) were studied by using a groupthink questionnaire constructed in accordance with the symptoms of groupthink described by Janis. It was hypothesised that groupthink could be described as a bipolar construct identifying either an omnipotent or a depressive variant of a group’s delusions about its own and other groups’ features. The questionnaire showed reasonably good reliability as a whole and a factor analysis identified three factors in line with the proposed theoretical model in which the two different types of groupthink can be distinguished. We propose that any group might have a tendency or predisposition to react in either of the two directions during provocative circumstances. The six different organisations exhibited different types of groupthink to a varying degree. A religious sect was the one most characterised by omnipotent groupthink, while a technological company and a psychiatric team seemed to be the ones with most features of depressive groupthink.     

Cognitive and attentional deficits in children vulnerable to psychopathology

Cognitive and attentional deficits were assessed in children with either a schizophrenic, an affectively disordered or a normal parent. The children were grouped both by their parents' DSM-II diagnoses (broadly defined group of schizophrenics and heterogeneous group of depressives)and by a new set of diagnoses (narrowly defined group of schizophrenics, unipolar depressive group and bipolar group). Children whose parents met the more stringent criteria for schizoprhenia performed somewhat more deviantly than children whose parents met only DSM-II criteria. In addition, the importance of splitting the heterogeneous depressive group into more homogeneous subgroups is indicated by the findings that children of unipolar parents generally could not be distinguished from children whose parents are schizophrenic. On the other hand, children of bipolar parents performed reliably better than children of schizophrenics. These findings are viewed within the context of current high-risk studies and psychological deficit literature and suggest that diagnostic issues require more attention by researchers in these areas.This research was supported by Grant MH 21145 from the National Institute of Mental Health. The authors are indebted to Lina Jandorf for assistance in testing the children and with the data analyses.     

Defensive patterns in reflective group supervisions at Child Health Centres

Reflective group supervision with infant healthcare workers has been described in several publications. It aims to enhance their ability to help distressed families, and to comprehend and relieve themselves of the distress that they encounter in such work. The ultimate aim has been formulated as an effort at increasing the professional's reflective function. The present article adds to the literature by applying an ego-psychological perspective on the group process and investigating defensive patterns in such supervisions. This approach includes a critical discussion of the place of the reflective function concept in psychoanalytic metapsychology. The article also suggests a Bionian perspective to account for skewed communicative patterns in groups, so-called basic assumptions. Some technical recommendations are provided on the frame in group supervision. They aim to disarm such defenses and facilitate the group participants’ possibilities of understanding and thus helping their colleague's problematic relationship with the family. To illustrate the discussion, and to help readers form an image of the supervision process, brief detailed accounts of such work are submitted.     

Suicidality in Bipolar Disorder: The Role of Emotion‐Triggered Impulsivity

A growing body of research suggests that impulsive responses to emotion more robustly predict suicidality than do other forms of impulsivity. This issue has not yet been examined within bipolar disorder, however. Participants diagnosed with bipolar I disorder (n = 133) and control participants (n = 110) diagnosed with no mood or psychotic disorder completed self‐report measures of emotion‐triggered impulsivity (Negative and Positive Urgency Scales) and interviews concerning lifetime suicidality. Analyses examined the effects of emotion‐triggered impulsivity alone and in combination with gender, age of onset, depression severity, comorbid anxiety, comorbid substance use, and medication. A history of suicide ideation and attempts, as well as self‐harm, were significantly more common in the bipolar disorder group compared with the control group. Impulsive responses to positive emotions related to suicide ideation, attempts, and self‐harm within the bipolar group. Findings extend research on the importance of emotion‐triggered impulsivity to a broad range of key outcomes within bipolar disorder. The discussion focuses on limitations and potential clinical implications.     

Group Therapy, 1976: An Overview

This article discusses short-term group psychotherapy with individuals suffering from an adjustment reaction or reactive depression precipitated by genital herpes. The authors describe their experience in conducting and supervising six such therapy groups and describe several therapeutic factors that emerged as central in the treatment of this population. Among these factors are relief from isolation, the exchange of information, a challenge to defensive denial, exposure to new ideas and behaviors, an opportunity to explore the developmental issues that typically emerge, and the discussion of ethical issues.     

Ethnicity, Culture, and Group Psychotherapy

Ethnicity and culture have great therapeutic import in the practice of group psychotherapy, especially given the increasing diversity of the population of North America, and this issue has not received appropriate recognition in the literature. In this paper these terms are defined, and the literature is reviewed. Ethnicity, culture, and psychopathology are discussed, focusing on treatment issues including transference, countertransference, resistance, group cohesion, group process, and multi-ethnic groups. The group therapist must be knowledgeable about ethnic and cultural issues in the lives of the group members in order to promote group cohesion and therapeutic effectiveness. The recognition and exploration of ethnic/cultural differences enhances the work of the group. Recommendations for treatment are discussed.     

Non-Traditional Women's Group

This paper focuses on an intensive large group experience for women that addresses issues of female identity and the cultural constructs that contribute to women's basic experience of self. It includes a discussion of self-concept and the social constructionist theory of the social, emotional, and psychological processes of the development of an individual's view of herself and the world. The author contrasts aspects of traditional group psychotherapy leadership, which tends to perpetuate society's devaluation of the feminine, with the leadership style of this workshop. The use of story and metaphor and other techniques used to achieve the workshop goals--including narrative therapy, guided imagery, movement and dance, and ritual enactment--are also discussed.     

Process and content in an outpatient schizophrenic group

Process and content issues were evaluated during the first six months of an outpatient schizophrenic group. Compared with groups composed of neurotic and characterological patients, the schizophrenic group scored higher in the Avoiding dimension of the Group Climate Questionnaire (GCQ-S). There was more cohesion and less interpersonal conflict as time went on. Although topics related to engagement and differentiation were discussed, there was no obvious GCQ-S evidence of these first two stages of group development. However, the data supported the presence of stage 3 (individuation) during sessions 20–26. Interpersonal topics dominated the group discussions, followed by issues involving reality-testing, expression of emotions, and advice-giving.The authors wish to thank Dr. K. Roy MacKenzie for his helpful comments on a draft of this paper.     

Group climate in an open-ended cancer support group

A number of well-described, controlled studies assessing cancer support group intervention support their effectiveness. All of these experimental groups have been close-ended and typically involve six to eight weekly sessions. Because many cancer patients are unable or unwilling to participate in closed, extended-session groups, there is particular need for analysis of the effectiveness of short-term, open-ended groups. Additionally, objective measures are needed to delineate the factors contributing to a successful outcome in cancer support groups. We used the Short Form of the Group Climate Questionnaire (GCQ-S) to characterize 23 sessions in an open-ended, short-term, Veterans Hospital based cancer support group. The cancer group scored significantly lower on the Avoiding and Conflict dimensions (p<.001) compared to a normative psychotherapy group sample. There was no difference on the Engaged dimension. This pilot study suggests that a cancer support group in this setting can create an environment where members are cohesive and take responsibility for their own change process, while keeping interpersonal conflict to a minimum. Based on these preliminary findings, we encourage controlled clinical trials examining the efficacy of open-ended cancer support groups.At the time of this study, Dr. Daroff was a resident in Psychiatry, University of California, San Francisco.     

An Experiment in the Prevention of Delinquency by Edwin Powers and Helen Witmer

A longitudinal clinical outcome study based primarily on a questionnaire method is the purpose of this two part paper. Techniques and approaches honed from fifteen years of para-analytic experience with one continuous Saturday morning group (seventy-five adolescents and young adults) are highlighted in this first part. Attention is focused on such pertinent issues as: lateness, selection, duration, individual sessions, physical setting, outside contacts, decreasing anxiety, parents and the important involvement of a female cotherapist. Catalyzing agents in the form of art therapy and mini-silent groups are described. The psychological position is presented for an age-mixed group (adolescents and young adults—age range twenty to thirty) to facilitate a natural flow of topics in the group dialogue rather than a “topic” format.