Hamlet at the millennium: assisting today's teens through the group psychotherapy process

This article reviews Shakespeare's Hamlet and its universal appeal 400 years after it was written. Focusing on the soliloquy "to be or not to be," the author notes that the play examines the fundamental philosophical question of whether to continue with life, or not. The article then discusses difficulties experienced by adolescents at admission to an inpatient psychiatric program by referring to them as modern day Hamlets. An examination of the theme of ambivalence as it complicates the assessment and treatment process is undertaken. A checklist of therapist responses to ambivalence in the conducting of inpatient group psychotherapy in an adolescent psychiatric hospital unit is offered.     

Brief group psychotherapy at retirement

Brief group psychotherapy as a method of treating psychological aftereffects of retirement is still in its infancy. It is therefore still possible to outline the whole field in overview. This paper examines the dynamics of aging and the relevant literature, discusses the conceptual issues involved, and describes techniques employed with this specific population. The typical cluster of complaints is portrayed, the psychological stressors associated with retirement are analyzed, and the various group-therapeutic modalities developed to counteract them are described. Furthermore, the rationale, process and characteristics of short-term group psychotherapy in the treatment of adjustment difficulties to retirement are reviewed. The clinical application of this approach, the therapist's particular roles and the therapeutic impact of this method are delineated.He would like to thank his co-therapist, Mrs. Sophie Bielawski, Reg. O.T., for her support and helpful observations and Drs. J. Regan and E. Sunday for their advice on methodolody.     

Combined individual and group psychotherapy: guidelines at the interface

The development of combined individual and group psychotherapy is split between the "separationists" and the "integrationists" with regard to therapists' handling of the interface between the individual and group sessions. To bridge the impasse, a high-benefit--low-risk series of guidelines is offered for therapists that includes techniques for analyzing patients' "cross-references" to the other component modality. The four guidelines provide for a harmonious balance that preserves the confidentiality of the individual sessions vis-à-vis the group, while enhancing the group interaction rather than draining it. The therapist guidelines maximize patient initiative in integrating parts of the self expressed in the individual and group sessions, while employing the least intrusive methods necessary to best integrate the processes into a unified combined modality.     

Inpatient adolescent and latency-age children's perspectives on the curative factors in group psychotherapy

Thirty-three adolescent and 11 child psychiatric inpatients were administered a downward revision of Yalom's (1970) 60-item Q-sort, which sets forth 12 putative curative factors of group, to assess patient perceptions of which factors in group therapy are most curative. The impact that age, patient level of functioning, and time in treatment had on which factors were most valued was assessed. Patient perceptions of the value of group compared to other treatment modalities were also assessed. Both child and adolescent subjects highly valued the factors of Hope, Cohesiveness, and Universality. Patients' level of functioning had limited effects on adolescents' perceptions, but did effect children's perceptions of what was most valued in group. The modest effect of time in treatment was attributed to the short duration of inpatient treatment. Implications for inpatient adolescent and child group therapy and future research are explored.Appreciation is extended to Mary Kelly, Elly Cobb, and Anna Csaky-Chase for their conceptual and editorial assistance.     

Forty years of group psychotherapy at the Menninger Clinic

Despite the skepticism and indifference to group psychotherapy that existed in the 1950s and 1960s within the psychoanalytic community in general and among the staff and administration of the Menninger Clinic in Topeka, Kansas in particular, a few clinicians there forged ahead in pursuit of incorporating this modality as an accepted treatment. After gaining some acceptance first in the hospital, we experienced a slow rate of growth, except with our trainees who were generally enthusiastic about group work. Many of them were intrigued first by their exposure to the group dynamics seminars and later by the didactic courses and supervised group work that eventually came to be required by the accrediting body for residency programs of the American Psychiatric Association. Visiting senior consultants and teachers, mainly associated with the American Group Psychotherapy Association, as well as an esteemed clinician from the Tavistock Clinic, also lent credibility and legitimacy to our effort. When group treatment began to be adopted by units of the Menninger Hospital in the early 1970s, there was a significant sea change in the attitude of the organization and group psychotherapy became a well established modality.     

Brief crisis group psychotherapy versus the initial sessions of long-term group psychotherapy: An exploratory comparison

An attempt was made to specify the therapist behaviors characteristic of the brief crisis group (BCG) approach, to assess how patients experience BCG on dimensions of session impact and group climat, and to describe the changes possible from BCG on measures of outcome by contrasting this modality with the initial sessions of traditional long-term therapy groups in a preexperimental design. Data obtained from four eight-session BCGs and three beginning long-term groups (LTG) were used for analyses. Patients were administered the Session Evaluation (SEQ) and Group Climate (GCQ) Questionnaires at the end of each group session. Two judges sat in on each session and coded the types of therapist interventions using the Therapist Behavior Categories (TBC) system. Aspects of self-esteem and symptomatology were assessed as indices of change over the 8-week period in a pre-post fashion. Therapists in BCG evidenced a distinct pattern of interventions during midpoint group sessions (sessions 3–6), placing a greater emphasis on challenging patient perceptions and providing information than their LTG counterparts. The therapists' use of self as an issue in BCG increased as termination approached and apparently served a more limited function than in LTG. Patients in BCG reported a more rapid development of a working group and experienced greater session benefit. Patients in BCG also reported lower levels of conflict and avoidance and a greater decrease in these resistance behaviors. As expected, BCG patients reported substantially greater improvement on most outcome dimensions at the end of the 8-week period. Results are considered as clarifying the approach to and impact of BCG psychotherapy.An earlier version of this paper was presented at the 15th Annual Meeting of the Society for Psychotherapy Research, Lake Louise, Alberta, June 19–23, 1984.     

The developing ego in group psychotherapy

Analytic group psychotherapy offers the potential for developing ego functions and enhancing identity formation. The nature of the interaction in group psychotherapy forces participants to deal with their perception of reality and revise their perceptions. After a brief review of the literature, focusing on the theoretical basis and ego development in analytic group psychotherapy, the paper discusses the following ego functions and gives an example of each: adaptation to reality, judgment, drive control, object relations (relationships with others), thought process and communication, defenses, affect differentiation, autonomy, mastery-competence, regulation of self-esteem, and frustration tolerance. The paper concludes with an example of assessing ego functions from a clinical vignette taken from one group psychotherapy session.