"Come on, Jack, tell us about yourself": the growth spurt of group psychotherapy

Group psychotherapy evidenced a growth spurt in the decade of the 1930s and prior to World War II. Following upon the pioneering efforts of the psychoeducators (Pratt, Marsh, Lazell) and the writings of the early analysts (Freud, Adler, Dreikurs, Burrow), the next wave of practitioners and theorizers popularized and expounded the use of the group treatment modality in hospitals, clinics, and private practice. A review of the seminal ideas and efforts of Jacob Moreno, Louis Wender, Paul Schilder, Lauretta Bender, Alexander Wolf, and Samuel Slavson continues the historical overview begun earlier in this journal (Ettin, 1988). In a continuing effort to call up the wisdom of the past in the service of the work of the present, the emphasis in this paper will be on practical application. Representative quotes will be embedded in the text to capture the tenor of the times, and special attention will be given to (1) theoretical underpinnings such as the proposed advantages, curative variables, and therapy goals of a group treatment; (2) the basic logistics of practice, including optimum group size, composition, membership and exclusion criteria, and length, frequency, and structure of the meetings; and (3) technical considerations, such as the role of the therapist and the techniques, procedures, and processes of the ongoing group endeavor, as well as the interface between individual and group sessions. In conclusion, it will be argued that group psychotherapy matured just in time to respond to the pressing need for efficient mental treatment mandated by the coming of the Second World War.     

The new member: "infanticide" in group psychotherapy.

While the variety of responses of psychotherapy groups to new members is wide, this article addresses those that are treatment destructive, that is, murderous in that they are aimed at the elimination of a new sibling. A number of frequently encountered destructive response patterns to new members are illustrated and categorized. It is suggested that survival of the new member is best insured by adequate preparation of the group so that the nucleus of powerful feelings activated in this situation can be felt and expressed prior to the addition of the new member. A clinical example of appropriate preparation is offered, and the contributions of group therapists to new member casualties are noted.     

Men,shame, and group psychotherapy

Male difficulties with shame and intimacy are described. Theories and research addressing the sources of the problem are summarized. Technical issues to keep in mind when conducting psychotherapy with men are also discussed. Finally, the special value of group therapy for treating men with shame-related problems is discussed and illustrated.The author would like to thank Drs. Robert Friedman, Robert Karen, and Amy Schaffer for their editorial suggestions.     

Self psychology,intersubjectivity, and group psychotherapy

The basic concepts of self psychology are presented. The three self-object transferences of mirroring, idealizing, and twinship are described and applied to group therapy. The therapist's role is: 1) to accept the patient's need to idealize the leader, the group, or the specific members; 2) to receive recognition and admiration; and 3) to understand the patients search for twinship. The group therapist also has the responsibility of teaching group members to have empathy for one another.     

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.     

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.     

Women, money, and psychodynamic group psychotherapy.

Developmental concerns and sociocultural expectations may keep female patients and therapists from addressing financial issues openly in group psychotherapy. Interpersonal theory provides a different view of nurturing that may help women leaders deal better with financial discussions in group. This paper includes a review of the literature on group psychotherapy and fees; feminist literature relevant to leadership; money management in group therapy; countertransference; and case examples.     

Individual psychotherapy as an adjunct to group psychotherapy

This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.     

Psychodynamic group psychotherapy.

The author provides an overview of critical factors in the working phase of group psychotherapy from the perspective of psychodynamic theory. The discussion is organized around a clinical vignette to illustrate various types of intervention such as past, here and now, future; individual, interpersonal, group as a whole; in group--out of group; affect-cognition; and understanding--corrective emotional experience. The critical "windows into the unconscious," transference, counter-transference, and free association, are also discussed in terms of the clinical example. The author concludes his article with a few thoughts about the future of psychodynamic theory in relationship to group treatments.     

Antidepressants in group psychotherapy

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.