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Abstract

A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit’s treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three–stage group designed to help patients achieve these goals.  相似文献   

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Emotional insight, is essential in order for therapeutic change to take place. Profound resistances to experiencing expressing, and understanding emotions are present in group members, the group as a whole, and the group therapist. Reasons for the three types of resistances are described. Specific therapist attitudes and therapeutic techniques are suggested to understand and effectively work through resistances at individual, interpersonal, and whole-group levels. Examples are given from an ongoing therapy group to illustrate the processes of understanding and working through resistances. Resistances on the part of the group therapist are identified and their possible effects on the group's resistance are explored.  相似文献   

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The homogeneous group has been the most common form of group therapy for chronically physically ill children and adolescents. The goals of these groups have included the provision of peer support, adaptation to the realities of physical illness, and acceptance of and cooperation with the medical management of the disease. The refinement of the theory of developmental ego psychology suggests that the heterogeneous group has potential for aiding the emotional maturation of the chronically physically ill. This paper presents examples of groups of latency-age children, early adolescents, and middle adolescents that included chronically physically ill with physically healthy peers. The groups were planned under the assumption that despite external differences, children and adolescents of a similar age identify with peers in terms of normal age-specific developmental needs and conflicts.  相似文献   

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I call attention to the metapsychology of sense, and the role sense plays–phenomenologically and symbolically–in the life of the clinician and the group. Each group member asserts influence in taking a role as the perceiver and the perceived, the senser and the sensed. We reach for sense, for without sense reference, we cannot grasp or even talk about psychic reality. It serves as sign and symbol, as metaphor, analogy, illustration, and model. Sense fixes experience yet may fixate experience and interfere with developing abstract thoughts. Clinical vignettes illustrate how the leader may utilize his or her particular clinical sensibility to reach the group and focus attention, to link sense to psychic qualities: to the personality of the members, the group culture and process, and the live clinical interaction.  相似文献   

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Subjective countertransference can sharply limit any group leader's effectiveness. However, a therapist can use the group itself to identify such a bias and to remove it as an influence. A five-step method for doing this is presented. These steps begin with introspection but hinge upon the analyst's turning to the group for the vital information that, in the end, clarifies the analyst's own perceptions and helps him or her free the group from the harmful effects of any bias.  相似文献   

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This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she “understands” because of having also grown up in an alcoholic family); (b) the “will to restore,” which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a “rush to recovery” on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) “countertransference goodness and availability” as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.  相似文献   

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A recently completed clinical trial that investigated the effectiveness of a group-oriented, day treatment program provided an opportunity to pursue a multidimensional approach to the prediction of treatment outcome. The sample consisted of 99 psychiatric outpatients, most of whom had received diagnoses of affective and personality disorders. The predictor variables included a patient personality characteristic (psychological mindedness), a group process variable (patient work), and their interaction. Univariate analyses revealed significant direct relationships between psychological mindedness and both work and favorable outcome, and between work and favorable outcome. Multivariate analyses indicated that psychological mindedness and work had independent significant relationships (additive or interactive) with several of the outcome variables. In combination they accounted for up to a quarter of the outcome variance. The results demonstrate the benefit of using a theoretically consistent multidimensional approach. The time-efficient nature of the predictor measures used in the study make them particularly amenable for use by clinicians and researchers.  相似文献   

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A developmental model of conducting a time-limited, short-term inpatient psychotherapy group is described. The therapist's primary goal in this model is to promote members' awareness of their dysfunctional interpersonal behaviors and the conflicts underlying these behaviors. The therapist pursues this goal by facilitating the group in resolving the conflicts of the four phases through which the group passes. In Phase I, the group addresses conflicts related to the establishment of trust. In Phase II, issues related to dependency wishes focused upon authority figures occupy the group's attention. In Phase III, conflicts within peer relation-ships become focal. In Phase IV as the group approaches termination, group members explore feelings related to the acceptance of loss. For each phase, optimal therapist interventions are described.  相似文献   

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