Primitive group process and therapist technique: An approach to short-term inpatient group therapy

In this paper seven formations of primitive group life are portrayed: the cocoon group and two pathological subformations within it — the fusion phenomenon and the isolation phenomenon; the symbiotic group; the emerging identities group; the common griping group; and the give- and- take group. Three broad categories of technical intervention are outlined for treating primitive groups depending upon which formation is occurring: enhancement of group safety; advancement of identity formation; and encouragement of discussion. The thesis of this paper is that therapists can work more comfortably and successfully in primitive groups with an awareness of primitive group life and with the use of therapist responses that address themselves to primitive levels of experience.     

Focused group therapy: An integrative approach

Focused Group Therapy (FGT) was developed within a research project on treatment for burned out patients on long-term sick leave. The core of FGT is to find and formulate an individual focus expressed in behavioural terms. This focus is then worked with in the here-and-now of the group therapy. It is argued that the use of common factors in group therapy, rather than a special technique, improves the clinical work. Thesupport factor in group therapy is understood in terms of cohesion, therapeutic alliance and goal-corrected empathic attunement. Thelearning factors that are stressed are the experience of being a part of a developing group, building on similarities instead of differences, affective communication and the implicit knowledge developed in new ways of dealing with interpersonal relations. Theaction factor is considered to consist of challenging interpersonal situations corresponding to the individual focus, which are mastered in the here-and-now of the group.     

Interpersonal conflict in group therapy: An object relations perspective

The aim of this paper is to demonstrate how object relations theory can be used to understand and regulate interpersonal conflict in group psychotherapy. Such concepts as projective identification, intersubjectivity and the analytic third are used to describe how conflict emerges in group psychotherapy and how it can be worked through. Case material is also provided to illustrate concepts and techniques in promoting a group's transition from a paranoid/schizoid to a depressive position. Positive aspects of the concept of projective identification are discussed including its use as a form of communication, a method of reducing anxiety and reintegrating previously dangerous and threatening aspects of the self.The paper was funded by Evan F. Lilly Memorial Trust Grant PV 13,067.     

An evaluation of group therapy for adolescents using social skills training

The present study investigated the hypothesis that social skills training is more effective in increasing socially acceptable behaviour in adolescents than is a generalized or non-specific form of group therapy. Forty-two subjects were selected to participate in the study from among adolescents referred for group therapy at two youth guidance clinics in Brisbane, Australia. The 23 males and 19 females were randomly assigned to one of three treatment conditions: a social skills training group, a non-specific therapy group and a waiting-list-for-therapy (control) condition. All subjects were assessed before and after treatment on five measures of social skills. Subjects in the social skills training group showed significant improvements on three of these measures while the non-specific therapy and waiting-list control groups showed no specific changes on any of the measures.     

Too close for comfort: the impact of dual relationships on group therapy and group therapy training

The healing power of psychodynamically oriented therapy and training groups rests, to a large degree, upon the quality of the here and now interactions. For the work to be effective, the basic principles of analytic group work need to be followed, including the observance of no extra-group contact. Simply said, nothing leaves the room. This principle has both ethical and clinical implications. It is my premise that while some forms of outside contact between members are relatively benign, other types are not. Outside contact that is built into the fabric and context of the group may pose a risk, as may be the case where dual relationships exist between members. The impact of dual relationships between group members in the particular instance of analytic training institutes is the focus of this article. What happens to the transference in this context when members reveal too much of their personal lives to each other through dual relationships is explored. It is suggested that extra-group contact can disrupt the balance between reality and transference distortion in group interactions in at least three ways: (a) "The Emperor's New Clothes" effect, (b) looping, and (c) gaslighting. Vignettes are presented to illustrate these phenomena and suggestions for reform are offered.     

An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder

Transdiagnostic models of anxiety, and cognitive-behavioral treatments based on these models, have been gaining increased attention in recent years. Preliminary efficacy studies generally suggest strong treatment effects, although few of these studies have examined to what extent treatment effects are similar across clients with different anxiety disorders. The purpose of the current study was to examine the efficacy of a 12-week transdiagnostic group cognitive-behavioral therapy for anxiety disorders and compare outcome across diagnoses. Mixed-effect regression modeling of data from 52 participants with anxiety disorders (predominantly panic disorder and social phobia) participating in an open outcome trial indicated that participants tended to improve over treatment, with no differential outcome for any primary or comorbid disorders. The results of this study add to the growing evidence base for transdiagnostic anxiety treatment models and provide preliminary support for the assumption that individuals with different anxiety diagnoses can be treated equally within the same treatment protocol.