Uses and abuses of theory: a group analytic perspective

Group therapy occupies a curious and ambiguous status in the overall mental health field: groups are recognized and marginalized, sought after and avoided, respected and dismissed as second best to individual therapy. Groups are now practised widely in many services, probably because of the pressure of referrals and increased concern about funding, but even then have a secondary status. The under-recognition of both the value and complexity of groups seems to parallel the problems of theory which are part of the group psychotherapeutic culture. Rather than attempt a comprehensive theory of groups in this article, I intend to present some of the problems about theory and its link to practice, focusing particularly on the ambivalence about groups that I see as a continuing concern. I do so from a position which values theory, seeing in theory the container of understanding which guides psychotherapeutic practice. I do not identify with a critical position which rejects theory. This position recognizes fully the risks and dangers of over-theorizing, the potential to distort human contact through a rigid adherence to theory; however, I write in the spirit of appreciating theory thoughtfully applied as without theory, our work might be impoverished and even impeded.     

Psychotherapy in a neoliberal world

The neoliberal regime has significant consequences for the psychotherapies. In particular, the idea that individuals is deserving of support from society and government when they need it – for example in managing the inevitable stresses of the life cycle – is being displaced by an ideology of total individual responsibility. Psychotherapies framed around relational conceptions of the self find themselves particularly out of key with this dominant way of thinking. Governmental approaches to developmental needs become more instrumental, measurement-oriented and ‘disciplinary’ in this situation. Market incentives and disciplinary sanctions are introduced to ensure that institutions and their personnel conform to governmental directives. There is pressure on psychotherapists to adapt to this instrumentalised environment to survive. However, ‘expressive individualisation’ was also stimulated by the cultural liberation of the 1960s, and survives alongside the ‘possessive individualism’ of neoliberalism. This alternative culture has not been entirely suppressed, and therapies continue to be sought which offer the possibility of self-understanding and growth, although the pressure is for such therapies to become luxury goods. What is at risk under neoliberalism is the idea that society should support the self-development and self-understanding of all its citizens, as an aspect of a modern kind of democratic citizenship.     

Joining and leaving a new religious movement: A study of ex-members’ mental health

The impact of membership in new, often socially contested, religious movements (NRMs) on mental health of members and ex-members is still a controversial question in the psychological literature. In the present study, we interviewed 20 ex-members of various NRMs who also completed questionnaires measuring several cognitive (need for closure, world assumptions) and affective-emotional (parental and adult attachment, social relationships, depression) constructs. Ex-members were then compared with current NRM members and with individuals not involved in NRMs. It appeared that NRM membership compensated for some previously existing vulnerabilities reported by members (insecure attachment in childhood, few social relationships, negative life events). However, this supportive effect did not persist after the destabilizing experience of disaffiliation. Yet, ex-members remained strong believers and were very inclined to spirituality.     

What members of Alcoholics Anonymous really believe

Many mental health professionals work with people who are members of Alcoholics Anonymous (AA) or may benefit from AA attendance. This article provides practical information about AA that professionals can use to understand and work with people in AA. It is a summary of a survey of 187 members of AA as well as synthesising the literature on AA. Specifically, it describes what AA is, the twelve steps and principles that underlie them, common AA expressions and how they can be used in therapy, common concerns about AA, and how to get more information about AA. Implications of how AA's steps and language can be incorporated into therapy, how therapy can facilitate working the steps of AA, and how to address consumers’ (or professionals’) concerns about AA are addressed.     

Treatment of Chronic Major Depression Using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP)

This article presents data from an ABAB single case design study of a 60-year-old Caucasian male diagnosed with chronic major depressive disorder. The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was utilized throughout treatment, and both BDI scores and diagnostic interviews revealed states of partial, and ultimately full remission during the course of treatment. A focus was ultimately placed on generalizing what the patient learned in-session to his outside life. Additionally, the unique design of this case illustrated that the patient experienced a moderate reduction in depressive symptoms, prior to the long-term alteration of his coping style. A stable change in his coping style was necessary before full and sustained recovery was evidenced.