Group Therapy

DR.V.VEERA BALAJI KUMAR PHD

HEALTH PSYCHOLOGIST
 Group psychotherapy or therapy

 is a form of psychotherapy in which one or more

therapists treat a small group of clients together as
a group.
 The term can refer to any form of psychotherapy when
delivered in a group format, including cognitive
behavioural therapy or interpersonal therapy,
 Usually applied to psychodynamic group therapy
where the group context and group process is explicitly
utilised as a mechanism of change by developing,
exploring and examining interpersonal relationships
within the group.
Grief – isolation – ostracized
 Group therapy extensions

 The broader concept of group therapy can be taken to

include any helping process that takes place in a group,
including support groups, skills training groups (such
as anger management, mindfulness, relaxation
training or social skills training), and psycho-
education groups.
 specialised forms of group therapy would include non-
verbal expressive therapies such as art therapy, dance
therapy, or music therapy
 Definition

 1) A type of psychiatric care in which several patients

meet with one or more therapists at the same time.
The patients form a support group for each other as
well as receiving expert care and advice. The group
therapy model is particularly appropriate for
psychiatric illnesses that are support-intensive, such
as anxiety disorders, but is not well suited for
treatment of some other psychiatric disorders.
 2) A type of psychoanalysis in which patients analyze
each other with the assistance of one or more
psychotherapists, as in an "encounter group."
 History

 The founders of group psychotherapy in the USA were

Joseph H. Pratt, Trigant Burrow and Paul Schilder. All
three of them were active and working at the East Coast
in the first half of the 20th century.
 In 1932 Jacob L. Moreno presented his work on group
psychotherapy to the APA, and co-authored a
monograph on the subject.
 After World War II, group psychotherapy was further
developed by Moreno, Samuel Slavson, Hyman
Spotnitz, Irvin Yalom, and Lou Ormont. Yalom's
approach to group therapy has been very influential not
only in the USA but across the world.
 Settings

 Group therapy can form part of the therapeutic

milieu of a psychiatric in-patient unit or ambulatory
psychiatric partial hospitalization .
 In addition to classical "talking" therapy, group
therapy in an institutional setting can also include
group-based expressive therapies such as drama
therapy, psychodrama, art therapy, and non-verbal
types of therapy such as music therapy and
dance/movement therapy.
 The milieu

 The total environment or milieu is regarded as the

medium of therapy, all interactions and activities
regarded as potentially therapeutic and are subject to
exploration and interpretation, and are explored in
daily or weekly community meetings
 How It Works

 Groups can be as small as three or four people, but group

therapy sessions often involve around seven to twelve
individuals.
 The group typically meets once or twice each week for an
hour or two.
 the minimum number of group therapy sessions is
usually around six but a full year of sessions is more
common.
 these meetings may either be open or closed. In open
sessions, new participants are welcome to join at any
time. In a closed group, only a core group of members
are invited to participate.
Group therapy session
 How It Works

 In many cases, the group will meet in a room where

the chairs are arranged in a large circle so that each
member can see every other person in the group.
 A session might begin with members of the group
introducing themselves and sharing why they are in
group therapy.
 Members might also share their experiences and
progress since the last meeting.
 The style

 The manner in which the session is conducted

depends largely on the goals of the group and the
style of the therapist.
 Some therapists might encourage a more free-form
style of dialogue, where each member participates as
he or she sees fit.
 Other therapists instead have a specific plan for each
session that might include having clients practice
new skills with other members of the group
 Guidelines and Rules for Group Therapy

 Maintain Confidentiality. It is essential that everything

said in group therapy is kept private by all group members
and leaders. Failing to adhere to this rule can undermine
trust within the group.
 Commitment to Attendance. it is vital that each member
attend every session, arrive on time, and stay for the entire
session. Absence or late arrival/early leaving can interrupt
the whole group.
 No Socializing with Group Members. Forming close
friendships or bonds with group members can interfere with
group success, especially if members become hesitant to
share information because of another group member.
 Guidelines and Rules for Group Therapy

 Communicate with Words, Not

Actions. People have different reactions to physical
contact, so expressing yourself through words
instead of physical actions is an important rule to
follow.
 Participate. Group therapy doesn’t have much of a
therapeutic effect if the members do not participate!
The potential for healing and growth rests on how
much group members are able to connect, share, and
learn from one another. It is essential for all group
members to truly participate for this treatment to be
effective.
 Research on effectiveness

 There is clear evidence for the effectiveness of group

psychotherapy for depression: a meta-analysis of 48
studies showed an overall effect size of 1.03, which is
clinically highly significant.
 Similarly, a meta-analysis of five studies of group
psychotherapy for adult sexual abuse survivors
showed moderate to strong effect sizes, and there is
also good evidence for effectiveness with
chronic traumatic stress in war veterans
 Research on effectiveness

 Group therapy has been shown to be as or more

effective than individual therapy for higher
functioning adults.
 Clinical cases have shown that the combination of
both individual and group therapy is most beneficial
for such clients (known as the "multiplicative" effect)
 Therapeutic principles
 Irvin Yalom proposed a number of therapeutic factors (originally
termed curative factors ).
 Universality
The recognition of shared experiences and feelings among group
members and realization that these may be universal human
concerns, serves to remove a group member's sense of isolation,
validate their experiences, & raise self-esteem
 Altruism
members can help each other, and the experience of being able
to give something to another person can lift the member's self
esteem and help develop more adaptive coping styles and
interpersonal skills.
 Instillation of hope
a member can be inspired and encouraged by another member
who has overcome the problems with which they are still
struggling.
 Therapeutic principles
 Imparting information
members often report that it has been very helpful to
learn factual information from other members in the
group. E.g. about their treatment or access to services.
 Corrective recapitulation of the family experience
Members often unconsciously identify the group therapist
and other members with their own parents and siblings in
a process that is a form of transference specific to
group psychotherapy.
The therapist's interpretations can help group members
gain understanding of the impact of childhood
experiences on their personality, and they may learn to
avoid unconsciously repeating unhelpful past
interactive patterns in present-day relationships.
 Therapeutic principles
 Development of socializing techniques
The group setting provides a safe and supportive
environment for members to take risks by extending
their repertoire of interpersonal behaviour and
improving their social skills
 Imitative behaviour – Role modelling
group members can develop social skills is through
a modelling process, observing and imitating the
therapist and other group members. For example,
sharing personal feelings, showing concern, and
supporting others
 Therapeutic principles
 Cohesiveness
It has been suggested that this is the primary therapeutic
factor from which all others flow. Humans have an
instinctive need to belong to groups, and personal
development can only take place in an interpersonal context. A
cohesive group is one in which all members feel a sense of
belonging, acceptance, and validation.
 Existential factors
Learning that one has to take responsibility for one's own life
and the consequences of one's decisions.
 Catharsis
Catharsis is the experience of relief from emotional distress
through the free and uninhibited expression of emotion. When
members tell their story to a supportive audience, they can
obtain relief from chronic feelings of shame and guilt.
 Therapeutic principles

 Interpersonal learning
 Group members achieve a greater level of self-
awareness through the process of interacting with others
in the group, who give feedback on the member's
behaviour and impact on others.
 Self-understanding
 This factor overlaps with interpersonal learning but
refers to the achievement of greater levels of insight into
the genesis of one's problems and the unconscious
motivations that underlie one's behaviour.
 Benefits of Group Therapy

 It allows participants to receive support and

encouragement from other members of the group,
helping them to feel less alone or isolated.
 an opportunity for group members to act as role
models for other members -- some participants will
naturally be more successful at managing certain
types of problems than others, and group members
can share their experiences and learn from each other.
 It is usually more affordable than individual
treatment since the therapist’s time is shared with
other clients.
 Benefits of Group Therapy

 Group therapy provides a safe environment for group

members to practice new behaviors without fear of
judgment.
 Interacting with others in group therapy will help the
therapist to see first-hand how a client interacts with
others and behaves in a social situation, allowing the
therapist to provide targeted feedback and suggestions
to each client
 Risks and side effects

 Talking and thinking about emotional problems can be

difficult. For this reason some people can feel worse
before they feel better. We work with you to manage
strong emotional reactions.
 For some people participating in a group session can
make them feel angry or makes the feelings of depression
worse, or feel that they are being criticised by other
group members.
 It can be painful to face the past and the truth, but
this has its limits and the therapist leading the group
respects that. The therapist also has their limits on what
they can understand and help with.