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.     

Reconstruction of the self: Life-span-oriented group psychotherapy

Abstract

Traumatic events affect the individual at many levels of functioning. They can have profound and lingering consequences for self-identity. Affective, cognitive, and behavioral components of the functioning of the self are experienced as disjointed, producing at times a sense of a lack of control of the self and a feeling of schism between the pre- and posttrauma identities. Therapeutic interventions drawing on constructivist theory and integrative techniques are useful in helping the traumatized individual regain self-understanding and mastery. The design and operation of a life-span-oriented group developed for work with individuals who have posttraumatic stress disorder are described. Guidelines for the structure and process of the group are provided, as are principles for technique selection and use within a structured, self-reflective group format.     

Couples psychotherapy group: Treatment of the married alcoholic

As part of an intramural research program of the National Institute of Alcohol Abuse and Alcoholism focused on the psychobiogenetics of familial alcoholism, a psychodynamically oriented married couples psychotherapy group was formed. Its purpose was to determine whether this modality could be utilized as an outpatient treatment approach to identify and modify interpersonal interactions that affect both drinking behavior and the quality of family and marital life. This paper, a clinical case report, presents follow-up data and disusses both themes that emerged in the therapy process and the usefulness of this modality in the treatment of the married alcoholic.She was formerly Chief, Unit of Family Studies, Laboratory of Clinical Studies, National Institute of Alcohol Abuse and Alcoholism (NIAAA).At the time this paper was written, she was a Research Social Worker, Laboratory, of Clinical Studies, NIAAA, Bethesda, Maryland.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Issues in the supervision of group psychotherapy: Countertransference and the group supervisor's agenda

Countertransference issues are of particular importance to the beginning group therapist. This paper describes the role of supervision in helping the beginning group therapist deal with counter-transference issues as they effect the formation of a group and the role that the group leader plays in facilitating therapeutic activity within the group. Particular problem areas and the countertransference they evoke and the role of supervision in working through are described.The author wishes to acknowledge the suggestions and support of Aaron Stein, M.D., and other members of the Division of Group Psychotherapy of the Department of Psychiatry of the Mt. Sinai School of Medicine.     

Countertransference in group psychotherapy

This paper attempts to up-date our understanding of countertransference in the therapy group setting. After a brief review of some of the psychoanalytic and the group psychotherapy literature dealing with countertransference, the paper points out the vulnerability of the group therapist and presents examples of possible countertransferential situations, such as stereotyped roles, reactions to external aspects of patients, and therapists' insecurities. It concludes by suggesting ways in which group therapists can become more sensitive to their countertransferences.     

Inpatient group psychotherapy: Cohesion facilitates separation

Inpatient group psychotherapy is affected by the time-limited nature of hospitalization. Although the brevity of treatment has been viewed by some as detrimental to patient improvement, other aspects of the treatment setting promote cohesion and allow group members to confront the threatening fears of separation and loss which likely prompted hospitalization. Separation issues are accentuated by the time parameters and the continual terminations of patients and staff. Unplanned terminations are seen as disruptive to the group process.