GROUP THERAPY QUIZ ONE

what is group therapy

Gathering of people that have similar issues that cause distress, thus they work towards it as a group

certain things/topics that people might have benefit more in group therapy than individual therapy such as sexual assault, trauma, loss, anxiety, depression

benefits of group therapy

•Efficient on seeing multiple people at the same time→ Individual therapy may be much slower; progress may be potentially more rapid

-Have this sense of universality

•Group members hold each other accountable, sometimes more powerfully than the facilitator

•People with social anxiety or those who lack socialization skills may greatly benefit from attending group therapy

When being a facilitator, one might to be careful when selecting certain people to be in group

•You might want to put people who have the similar severities together

•Facilitators have to think of who’s going to be in the group and how that will impact the dynamic

•Want to be thoughtful about the diagnoses that are put together as well

EX. you wouldn’t have a sexual perpetrator in a group full of people who are there for sexual harassment

role of the group therapist/facilitator

•The facilitator has influence over the group, thus you don’t want one who takes the ‘know it all’ role

•Members might perceive their feedback as unimportant or may not want to participate because of it

•Thus, the facilitator should create an open atmosphere where everyone is seen as equal and everyone’s feedback is welcome

self reflection in group

•Self reflection: what impact did that interaction between the group members have on me; did it trigger feelings of anger, sadness

•ex. if there is an interaction in therapy, such as a conflict, there should be a period in which group members reflect on what just happened in the group

what are the 11 primary factors in group

1.Instillation of hope

2.Universality

3.Imparting information

4.Altruism

5.The corrective recapitulation of the primary family group

6.Development of socializing techniques

7.Imitative behavior

8.Interpersonal learning

9.Group cohesiveness

10.Catharsis

11.Existential features

instillation of hope in group

•In order to instill hope, we need to understand what the clients' expectations of treatment are→ Send the massage to members that therapy isn’t a definite cure, rather a step towards a long process of healing

•Helping them understand that therapy is a process; not necessarily feel great after sessions( some will have pos or neg emotions)

Need to come in with people’s success stories that could instill hope to the group: stories have to be confidential→ having a group that doesn’t just have beginners bc they cant really share those stores of hope; ex. AA or survivors group→ this feeling of ‘it will get better’

universality in group

•Sending the message that ‘we are all in the same boat’: When people come into the group they feel very unique and different, which is not a positive message, thus we want to send the message that ‘we all have things here that we need to work on

•Many come to group feeling shame or that they’re bad: that universality helps them feel apart of the group regardless of their past behavior or actions→ Might feel shame about being abused, shame about overeating, carrying feelings of guilt

What would be one thing people would be least likely to reveal in group?

Common answers were basic feelings of inadequacy, sense of interpersonal alienation or some sort of sexual secret

imparting information in group

•Psychoeducation is important: Groups in which you choose a topic, you might have a worksheet to complete OR you may also process/ self reflect on the information that was given to you

•The ideal group is one of partnership and collaboration, rather than prescription and subordination

•You have to set ground rules in group, if not it might become problematic

•Most of what people gain comes from didactic information not implicit information

• Avoid saying ”I think you should” because it rejects other potential options a person has

Common Ground Rules that are Imposed During Group

-Mutual Respect for each other: don’t speak over others, allow others their time for their group

-Use of ‘I’ statements: “I felt sad when I heard you talking about your experience”

-We don’t give advice to group members: setting yourself as an expect among the members and the members might blame you if they follow your advice and it goes wrong→ learning more effective ways to how to give ‘advice’

-Confidentiality statements: leaders cannot promise that everything said in group will remain confidential but they can create an atmosphere where confidentiality occurs

-Dress attire: no sunglasses and hats ( it restricts what they can get out of group, hides one’s emotions); doesn’t mean you should exclude them rather go “I noticed you’re wearing x today, tell me more about that’

-Chairs need to stay as they are

altruism in groups

•In therapy groups, members gain through giving help to others→ They profit from THE intrinsic VALUE of giving

•You have many clients who think they have nothing to give, thus group can be very powerful to them; group experience allows them to realize that they do have something to give

the corrective recapitulation of the primary family group

•Basically stating that ‘the real you will eventually come out during group’

-Group setting has a lot people that can represent people, such as mothers, fathers, siblings, etc.→ Group resembles a family unit

•Recreation occurs more rapidly when groups are authentic and spontaneous

•Early experiences need to be relived correctively→ There needs to be a corrective experience; not just cathartic

•Re-exposed with Repair: issue is exposed with the conflict but then it is repaired

development of socializing techniques in group

•Some groups are more explicit while others are not; however in all therapy groups one will learn social therapeutic techniques

•Learning can be direct or indirect suggestions regarding how to socialize effectively

•Intent vs Impact in Group: We need to be aware as members in group that one can have intentions of not hurting someone but can still have a very strong impact

imitative behavior in group

•Group members learn from watching one another, not just the therapist; this is why it’s important for therapist to model effective behavior in the group

•This imitation of behavior comes from Bandura: states that we imitate behaviors of models

•Members do this unconsciously, they’re learning vicariously→ Bandura called this vicarious or spectator therapy

interpersonal learning

A broad and complex therapeutic factor

•It’s a lifelong process that takes place; we are gaining insight during the learning process

•Working through the transference; working through the original experience a person had with repair, thus experiences a corrective emotional experience

what are the three concepts one must understand to see how interpersonal learning meditates change for an individual

•The importance of interpersonal relationships: we cannot do without them, even if we have a demeanor of indifference about them; those relationships are important and necessary

•The corrective emotional experiences

•The group as a social microcosm: the group is a  reenactment and an opportunity for one to practice new behaviors from what we do in the  real world

John Boldly and his attachment style theory

•John Boldly stated that ‘we need to be attached in order to survive’

•Was interested in the developing child

Stated that a child that is developing cultivates and emphasizes traits and aspects of the self that are approved by others→ beginning at a very early age we cultivate and emphasize those traits in parts of ourselves that others approve of

Daniel Seagull and his attachment style theory

said “interpersonal relationships are interconnected with our mind and brain

Harry Stack Sullivan and his attachment style theory

•stated in his interpersonal theory of psychiatry that “personality is the product of our interactions with other humans”

•Coined the term parataxic distortions, meaning having the tendency/proclivity to distort the of others

We relate to others on the basis on a personification existing in our inner psychological world( how you interact with others is based on how you perceive them and your perceptions of others is your creation of them)

•EX. you see two people whispering to each other, you might automatically assume that they’re talking bad about you, even thought that is not true-> that is one’s reality

group as a social microcosm

•During beginnings of Groups: More guarded, present yourself the way others you think want you to see; eventually members become more like themselves

•Therapists look at conflict as an opportunity for therapeutic change: they look at it as something understandable that happens, thus it allows those in conflict to have a corrective emotional experience

•Want to address the most pathological behaviors quickly and in the beginning→otherwise, other members might become irritated and thus disrupt the flow of the group; Other things that you might want to quickly address in group include: lack of engagement or communication in group, monopolizing the group, a person who’s invalidating and hostile, interrupting others frequently

•Silence in group: can be problematic but it can also be therapeutic→ KEY is that it’s very important for the therapist to not break the silence, their job is to allow the group to make their own work with silence

what kind of questions should the therapist ask in group

open ended questions; they further group discussion

Should one run after a group member if they suddenly walk and leave group?

•No, unless we perceive that the person is in a state of emergency

•If we run after them one could be faced in a power struggle; the group keeps going regardless if someone leaves→ The person who leaves eventually comes back to group

•Co-therapy is great for a situation like this

group cohesiveness

•group therapy analog to relationship between the therapist and client in individual therapy; Analogous to the client-therapist relationship in individual therapy

•In group, it is not the client-therapist relationship rather the cohesiveness of the group that instills therapeutic change

what is another way to define group cohesiveness

•Attractiveness of a group for its group members; level of attractiveness that you have towards the group

•One wants to be there, they might feel attracted towards the group

•When a group is cohesive, one feels comfort and a sense of belonging

Those seeking mental health services have two common difficulties, what are they

1.Establishing and maintaining meaningful relationships with others

2. Maintaining a sense of self-worth: they feel worthless, inadequate

the group self reinforcing positive loop

•Group forms a positive feedback loop

•  Trust –> self-disclosure –> empathy –> acceptance –> trust

•EX. you expect the members to judge/ignore you when stating your point of view, but when they rather demonstrate support it encompasses this sense of acceptance in you

•It is important to remember not to self disclose if you don’t feel comfortable doing so

cohesivenes

•The result of forces acting on group members that allows them to remain in the group (level of attraction to the group)

•The energy that acts on group members and it’s cohesive in a sense that group members stay in the group

Paradoxical Intent in group

•when people begin to reveal their own personal inadequacies, and the group is still being accepting towards that person, this negative reinforcement doesn’t happen because of this paradoxical intent

•The group members  continues to be supportive of that person that’s intention is to be rejected

•Person engages in self disclosure, this disclosure itself is devalued through group norm, thus increasing the group’s expectations of that person; this causes the person to alter thoughts/cognitions about themselves when having this positive experience

dropping out of group

•In groups dropping out can become contagious

•When members drop out it challenges the group’s sense of worth; the group doesn’t  think they're worthy of helping others or sense of effectiveness→ Thus, for a group to be effective there needs to be stability and low drop out rates

•If someone drops out, a new member needs to be added to continue a solid group going

•A sense of loss that the members might be feeling needs to be processed

the therapist’s basic tasks in group

•Because the therapist serves as a model in group, they need to engage in open communication and judicious self disclosure: expression needs to be for the purpose of helping the members and the group as a whole

•The leader needs to have therapeutic relationships with the group members, being consistent, positive,  empathic, and culturally attuned

•All effective psychotherapy needs to create and maintain a group,  build a group culture, and therapist needs to activate and focus on the here and now 

•Therapist needs to be concerned, genuine, empathic, and emotionally engaged

creation and maintenance of the group is the therapist’s responsibility

-Creation of the group is both literal and abstract: the pre-group experience that members have before the session even starts; the time and place in which the group will occur

•Choosing members, preparing members for participation, setting time and location is important→ Selection of members also play a role in group cohesiveness

•Drop-outs are the therapeutic failure: it’s not therapeutic for the group members of the group that drops out; It is important for when members drop out to add new members

culture building in group

•As you’re building the culture, we have an unwritten code of behavioral rules called norms that guide group interactions

•You also send the message that the group and its members are the agents of change-> they are responsible for the group; they set into action those therapeutic factors

•When one sets a group culture you send the expectation that members are free to comment on immediate feelings that they have towards the group

constructing norms in group

•Group leaders sometimes construct norms without intending to: Our behavior plays a large powerful role in the construction of these norms, especially new members that are looking at us for how to behave in group

•If you as a group leader shows up late for group because there’s a co-leader, one is sending the message of not being on time either→ This behavior sets an un-written  group norm that members do not have to follow

positive reinforcement in group

•By doing positive reinforcement, you increase the behaviors that you want to see

•EX. Maybe during one session if everyone shows up on on time you might tell them ‘great job’

role of therapist in group

•Judicious self disclosure: Therefore, it’s important for the therapist to model self awareness for the members to model this as well->need to demonstrate that as the therapist we are also human, being nonjudgemental

-Look at the pathologies among all group members

•You don’t want to model the ‘expert therapist’ stance because then clients might model that stance as well

•A good way to admit one’s fallibility  as a therapist you can say “I wish I understood then what I understand now”: good way of building rapport with clients, appearing more human to them

•The responsibility is in us as a therapist to create the group that we want to create in order to see the progress that you wish

•Be honest and spontaneous but always keep the needs of the group as a priority