Dynamics and Techniques of Group Psychotherapy in Private Practice

In rearing a mentally retarded child, parents are confronted with a number of taxing stresses and problems. As a result, many in this parent population need and could benefit from a social support network. Unfortunately, such networks often do not exist or parents make no effort to join them. One seemingly useful means of providing a facilitative social system for parents of retardates is via the support group. In this article, two support groups—each developed to assist parents in adjusting to their retarded children—are described. Also, the process stages of these groups are discussed.     

The Relation between Individual and Group Conflicts in Psychotherapy

Abstract

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference–countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconsciousaswellasconscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.     

Comparison of Dreams in Individual and Group Psychotherapy

This article gives specific reasons and evidence why group psychotherapy is the treatment of choice for addictions. Utilizing object relations theory and the self-psychology of Kohut, the authors present a model of group psychotherapy that combines these perspectives with those of Yalom's interactional group psychotherapy. Agreeing with Kohut and other object relation theorists, the authors view addiction as a condition that is the result of a person's misguided attempts at self-repair because of deficits in psychic structure. Vulnerability of self is the consequence of developmental failures and deprivation. Substance abuse only exacerbates this condition leading to exaggerated difficulty in regulation of affect, self-care, and characterological pathology. Abstinence is usually required as the first step in arresting this process and establishing a treatment regimen that will allow the vulnerabilities of the self to be altered and restored. This article suggests that this recovery and treatment process is best accomplished in a group therapy setting that is conducted within the guidelines of the principles of object relations theory and a modified version of Yalom's interactional group therapy format.     

The Effect of Group Psychotherapy in Reducing Resistance to Individual Psychotherapy: A Case Study

Abstract

Cohesion in group treatment of spouse abusers plays an important and often overlooked role. Involuntary abuser groups can benefit from cohesion, but due to their unique structure, cohesion may develop differently than in voluntary psychotherapy groups. Initially, abuser groups may develop premature levels of cohesion that can make group members unwilling to express conflict, develop intimacy, and take responsibility for their actions. Understanding the abuser personality and the unique characteristics of involuntary abuser groups can shed light on why cohesion develops the way it does and the importance it plays in abuser groups. Developing effective interventions that target premature cohesion can help the group members express conflict, develop intimacy, and take responsibility for their actions, thus bringing about therapeutic levels of cohesion.     

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。     

Group Psychotherapy in the Treatment of Some Neurodermatoses

The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these group; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.     

Group Psychotherapy in the Treatment of Acute Emotional Disorders

The authors have constructed a Dutch version of Yalom's “Questionnaire for Curative Factors.” This Dutch version has been administered to 134 participants of 22 psychotherapy groups in various psychiatric services in the Netherlands. Results concerning validity and reliability of the instrument are presented, as well as concerning the homogeneity of the hypothesized “factors.” Differences between types of groups and categories of group members were tested by means of techniques of analysis of variance (ANOVA). Multiple regression analysis was applied in order to detect variables of differential qualities on one or more factors. Only the factor identification, neglected in literature on curative factors, was highly predictable.