Student cotherapists as facilitators for group patients

This article discusses the clinical training of group therapists, the conditions under which students function as cotherapists, and the ways in which having a student trainee as cotherapist to an experienced group therapist can enhance or facilitate the therapeutic process for group members. Such enhancement can be brought about directly by: stimulating the emergence of new material; providing different perspectives and different reactions; providing different models; bringing out different transferences; affecting the working alliances; and requiring patients to deal with the loss of the cotherapist. It is brought about indirectly by: each therapist picking up on the blind spots or distortions of the other; each perceiving and discussing in supervisory conferences the other's countertransferences; and using weekly supervisory conferences to develop an increasingly cooperative relationship.     

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.     

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.     

Terminations

Whether the person leaving the group is a group member or a group therapist, the basic dynamics of separation are the same, involving the separation process as well as mourning. Terminations evoke ambivalent feelings of both separation-pain and hope. Group members and the departing person experience a loss, which reminds them of other losses, and the departing person (group member or therapist) may also experience some guilt. Any termination will have an effect on the-group-as-a-whole, as well as on the individual members, and must be dealt with prior to the actual leaving, as well as after the termination.     

Acting out in group psychotherapy

Acting out is a common occurrence in group psychotherapy. After a brief review of relevant psychoanalytic and group psychotherapy literature, this paper presents various kinds of acting out by the individual group members and the handling of such acting out by the therapist, discusses acting out by the group as a whole, and gives a brief overview of acting out by the group therapist. Specific examples are given of acting out and ways of dealing with it.     

Group member contacts without the group therapist

After presenting some of the arguments against patients having contact with one another outside the regularly scheduled group psychotherapy sessions with the therapist, we present our counterarguments. Rather than forbidding extragroup socializing, thereby assuming the role of moralistic, punitive parental authorities to be deceived or challenged, we accept that such socializing is likely to happen and then establish beforehand the rule that information about extragroup contacts is to be shared with the entire group during regular therapy sessions with the therapist. In this way, the extragroup behaviors are dealt with just as any other material in group, i.e., searching for the underlying dynamics. Some positive aspects of extragroup socializing, as well as some negative aspects, are discussed, with examples taken from clinic groups and private practice groups.     

The impact of group psychotherapy on the self-image and self-feelings

Group psychotherapy is presented as an effective way of changing the self-image and self-feelings; the image of the self and feelings about the self being brought into awareness by the group process. After a brief review of relevant literature, group-specific experiences that affect the self-image and self-feelings are described. These include: the mirror phenomenon and triadic relationships; resonance; direct confrontations and challenges from other members; comparing oneself with, and differentiating oneself from, other members; and experimentation with new, different ways of relating to other group members. Some of the experiences of group members and, finally, the significant role of the therapist in this process are described.