This has inspired numerous efforts to utilize the healing force of the group to meet the therapeutic needs of a wide range of clients— individuals at all phases of the life cycle with highly diverse problems needing treatment. Simultaneously, virtually all schools of psychotherapy have embraced group practice and have attempted to incorporate their respective conceptual frameworks into group work.
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As a result, group psychotherapy is not based on a single theoretical perspective, but takes from many theories what seems to be most helpful. The techniques used in group therapy can be verbal, expressive, psychodramatic, and so forth.
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The approaches can vary from psychoanalytic to behavioral, from Gestalt to encounter, from existential to rational. Each approach has its advantages and drawbacks. Groups differ not only in their theoretical approach, but also in their focus and application.
Groups can be categorized as either small or large, short term or long term, outpatient or inpatient, ongoing or time limited. Psychotherapy groups can be open groups or closed groups. Open groups replace members as they drop out or terminate. Closed groups, after a period of forming, do not allow new members to join.
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Psychotherapy groups can be heterogeneous or homogeneous. Heterogeneous groups have members with quite different presenting diagnoses, complaints, or life problems.
Homogeneous groups are made up of people with the same presenting diagnosis, complaint, or life problems. Families also may be treated using a group modality—referred to by names such as multifamily group psychotherapy, family group consultation, and others. Some psychotherapy groups focus on a specific area of common concern, such as relationships, anger, stress-management, and so forth. These groups often have an educational or teaching component and are frequently more time limited than general process-oriented psychotherapy groups.
These homogeneous groups are especially beneficial for providing support, normalizing the concern, and encouraging modeling of participants who are successfully addressing their issues. Group therapy is also used in psychiatric hospitals, general medical hospitals, and outpatient clinics to help clients deal with the psychological impact of terminal illness, cancer, attempted suicide, and stress.
Individuals with profound ego impairment can be treated in psychotherapy groups in hospital groups, post-hospital follow-up groups, and day hospital groups. Group psychotherapy is extremely helpful as a part of an overall institutional treatment program in combination with psychological medication, individual therapy, and milieu therapy.
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Large psychotherapy groups are usually conducted in community or institutional settings, and such groups are often organized to work on a specific problem—for example alcoholism, obesity, rehabilitation, or another area of concern. The prototypical psychotherapy group is the open, heterogeneous, outpatient group that meets weekly for 6 months or more, admitting new participants as necessary to maintain a critical mass.
The group therapist, leader, or facilitator chooses as candidates for the group those people who can benefit from group interaction and who are likely to have a useful influence on other members in the group. Most screening and selection procedures are subjective and rely on the intuition and judgment of the group leader.
Usually, a moderate amount of social ability and psychological-mindedness, along with some commitment to change interpersonal behaviors and some positive expectations about the benefits of group treatment, are considered important for participation in a group. Certain individuals are less likely to benefit. These include people who are extremely self-centered, acutely psychotic, highly paranoid, or actively suicidal, or extremely aggressive and hostile people, with a tendency to act out. Group psychotherapy is the deliberate effort to alter the feelings, thinking, and behaviors of group members.
In group therapy, past experiences, experiences outside the therapeutic group, and especially the interactions between the members of the group and the therapists become the material for the therapy. Essentially, the problems that the clients experience in daily life will also show up in their interactions in the group, allowing the problems to be worked through in a therapeutic setting, generating experiences and behaviors that may be transferred back to life outside the group.
Members of the group share with the others in the group personal issues that they are facing. Participants can talk about events they were involved in during the week, their responses to these events, and the effectiveness of those responses. Other participants can react to words and behaviors, give feedback and encouragement, provide support or criticism, or share their thoughts and feelings following interactions.
The leader does not determine the subjects for discussion, as subjects rise spontaneously from the group. The members in the group feel that they are not alone with their problems, and they discover that there are others who are experiencing similar issues. The group can become a source of support and strength in times of stress for the participant.
The feedback they get from others on behavior in the group can make them aware of maladaptive patterns of behavior. At that point, they can change perceptions and points of view, and they can adopt more constructive and effective reactions. The psychotherapy group can become a laboratory for practicing new behaviors.
Group psychotherapy is suitable for people with a large variety of problems and difficulties, from people who would like to develop their interpersonal skills to those with emotional problems such as anxiety, depression, and so forth. While support groups are developed for people in the same situation or crisis e. As noted earlier, the likelihood that group participants will manifest their particular issues in the group makes group psychotherapy especially effective for people with interpersonal difficulties and problems in social, personal, or work relations.
Group psychotherapy is usually more cost effective than individual therapy, and possibly even more clinically effective.
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