The Motivational Fabric

Where do I fit in How do I find a safe place for myself within or outside this (or any) group and what does it cost me to stay there These very human questions form part of the motivational fabric of any group. The answers are complex, weaving together earlier relational experiences, current social concerns, and the present moment of group life. Staying in the moment of group encounter long enough to examine these questions can be difficult, however, requiring the ability to be both aware of...

Remembering When Therapist As a Historian

If we possess our why of life we can put up with almost any how. Listening intently to the language of others offers us the opportunity to create images that stimulate the senses (Barlow, Fine, Pollio, & Pollio, 1977). Telling stories of lived moments is a creative opportunity to verbally image a moment in time that can provide a perspective from which a shared experience can elicit visceral responses in the group process. Words have an energy that can ignite the listener it is the awareness...

Intervention Guidelines

SIT is a flexible and individually tailored alliance-based intervention used with individuals, couples, and groups. Sessions are as short as twenty minutes and range in frequency from eight to forty sessions. SIT has been utilized successfully to prepare patients undergoing medical procedures (Meichenbaum, 2005) and with patients suffering from anxiety (Suinn, 1990), stress disorders, addictions (Meichenbaum, 2005), and anger control problems (Deffenbacher & McKay, 2000). The Joint...

Assertiveness

A patient with a history of vicarious trauma who abided by her mother's injunction to be nice lest chaos ensue, developed a disengaged style of relating to others in the group. After many months of Group ,4s a Place to Practice New Behaviors group work she was able to practice alternative ways of engagement. Initially very tentative, she would preempt her response to her peers with I'm going to try something new as I want to practice saying what I think so please let me know if this is...

Response Of Clients To This Intervention

Clients usually realize that coping with conflict with the group is a helpful way of dealing with it. They learn that when they are self-focused, most of all on themselves or specifically their condition, social interactions become more complicated as they introject what is transmitted by others, i.e., condolences, pity, and or affliction. Speaking about it together inside the group elicits feelings of not being alone and the potential of other possibilities and strategies for personal...

An Intervention Of The Therapist Selfsearch

Therapist self-disclosure, if and only if it is in the interest of the client, may be the prescribed intervention. Over many years of running groups, I have found that there are very few interpersonal conflicts or experiences presented by clients with which I myself could not identify in varying degrees. In fact, I use the totality of my being in order to understand what a client is trying to relate in the hope of feeling what the client is feeling. This is similar to two tuning forks...

Contraindica Tion

It has been our experience that there is not any population for which these interventions are contraindicated although individuals must have some introspective ability. If one has the ego strength to be in a process-oriented group therapy setting, then working on mindfulness will enhance the group process. These interventions can be applied to individuals, the group, and the therapist to enhance mindfulness in the group setting. Gerrner, C. K., (2005). Mindfulness What is it What Does it...

Whose Chair Is This

Soon after the formation of a new therapy group, the alert leader will hear members make references to chairs as they enter the group room. Where am I supposed to sit We always sit in the same places guess we're in a rut Maybe I'll sit in the leader's chair tonight (nervous laughter). People quickly choose places and the topic of discussion is dismissed as settled. However, a group event has already taken place that is rich with meaning and learning potential. This intervention is designed to...

Second Stage Developing An Interpersonal Relationship With The Horse

At this stage, riding is combined with handling and taking care of the horse. Riding lessons included galloping while standing up and sitting down, as well as maneuvering the horse around obstacles which demanded more precise handling of the horse. Handling and taking care of the horse included brushing and washing of the horse, and putting on the saddle. The group members also cleaned the stables. Greater emphasis was placed on group work, which involved rubbing shoulders with one another and...

Short And Longterm Group Populations

The intervention of using mindfulness in group psychotherapy is effective with most patients both in short-term and longer-term groups. In a short-term group, this intervention is best limited to building mindfulness of feelings and bodily sensations which are already close to awareness. In a long-term group this intervention can be used to teach them to be mindful of feelings and bodily sensations which are less congruent with how they want to perceive themselves. This intervention is best...

Responses To Intervention

When this intervention is introduced in an existing group that is not used to discussing the fee payment, the group members are likely to express shock, outrage, and resistance. As in many families and cultures, the discussion of money may have been taboo, so that the status of fee payment, an essential component of the group's health, has become a group secret. Once the members see the benefits of this discussion, however, they are likely to participate more willingly. New members may be more...

Inter Vention A Ttention A Ttention Now Hear This

Joining a group was both a frightening and stimulating prospect. The group experience exposed me to a cross-section of society, which included professional men and women, married and unmarried, and parents living with and without children. Among the most salient of challenges was my fear of venturing out of my comfort zone to self-actualize in an area outside my home-making duties and find a job in the workplace. One of the difficulties of achieving and living a more psychologically healthy...

Step 1 Acknowledge Something Happened

One evening, soon after the initial check in, there was an interaction between long-term members Ralph and Ronald, which also served to avoid something upsetting one of the newer members had mentioned in check in. I started to comment on it and got their names reversed. Suddenly, I could see by their expressions that I had done something. An instant review made me realize that I had reversed their names, so I rolled my eyes in comedic recognition. Both started to laugh, followed by other group...

Mindful Individual

Most times, when people enter psychotherapy, they are not mindful of themselves or of others. They often enter therapy unaware of what they feel, why they feel as they do, and in what context these feelings are likely to be elicited. There also tends to be an unaware-ness of the feelings and motivations of others. Many use projection rather than mindful awareness when trying to understand what another person is feeling. This of course leads to difficulties in relationships. In addition, people...

The Profundity In A Word

No one word in the English language may stir so many strong emotions. Now imagine yourself being older, elderly. Your spouse, your partner in life, your best friend and confidant, dies. You are alone. The scene is a large room in a senior citizens' activity center. The empty chairs start to fill with elderly people. They have all lost a spouse. They are alone. Anxious. Bereaved. Hopeless. Scared. They are attending a bereavement group for the first time. The session starts. Based on my...

The Inter Vention

The overriding goal for my psychotherapy groups is for the participants to view themselves less as targets of others' ill will, a result of poor parenting, or as individuals who are innately bad in a world of good people. By working toward conscious awareness, each participant has the opportunity to rewrite his or her own view of their world. It is in this rewrite that he or she is able to take responsibility when needed and forgive when necessary. The work for the therapist in this...

Sample Statement

The fee for a ninety-minute session is (amount). This fee is a payment for your place in the group and is due for all scheduled group sessions except for three planned absences per year, major national holidays, and any session cancelled by the therapist. Requests for exceptions must be made in advance during a group therapy session. At the first group session of each month, please bring a check for the previous month, made out in advance, and payable to (therapist's name). The policy is a...

The Situation Before The Intervention

In the early spring, one group member shared her joy at being pregnant but she also felt discomfort that the baby was incorporating her. Later that spring, another member told us she was pregnant. She had not yet let her mother know because she first wanted to feel separate from her mother. Her mother incorporated her too much. Before the summer vacation, a third member mentioned she was expecting her third child. She also had problems relating to her mother. The group now had three pregnant...

Contraindica Tions

This intervention may have contraindications if the client is not fully educated about the purpose of the skills training from the start. The client must understand that assertive communication is for the sake of the client and not for the sake of changing others. Clients must recognize that standing up for their rights and expressing their views will provide them with a greater sense of freedom, enhanced self-esteem and self-worth, and assist him or her in eliminating self-destructive...

Inter Vention Description

We are in a room with a group of individuals who are sharing a specific situation in their lives that elicits suffering and with which they have been working together for a number of sessions. They have now gone through a phase of emotional relief in the group and they are beginning to perceive how their particular personal event has affected their present-day social relationships. They are now at a point where they feel the need to readapt their daily lives in relation to how they are being...

Typical Response To The Inter Vention

My clients feel a renewed sense of self-esteem in nearly all aspects of their lives as their skills improve. They feel hopeful that they can conquer obstacles that come their way without retreating into a world of fear that has paralyzed them in the past. This is evidenced by observing the group members using their newfound skills appropriately week after week during group sessions with decreased anxiety. Interestingly, I have noted a secondary'benefit to this training not only for the...

The Fourstage Intervention

The first intervention occurs before the patients ever arrive and involves the therapist paying attention to the medical comfort needs of the patients. Patients with compromised immune systems may need to have bottled water available. Patients on multiple medications may need to have snacks to take medication during the group time, and they may need to have a convenient bathroom easily available. Patients may not be able to walk stairs or navigate large parking garages. In the second...

Conclusion And Contraindication To This Inter Vention

The purpose of this kind of procedure is to show that when one of our circumstances becomes a threat, it affects not only oneself but also one's social self-esteem as we are perceived by others. Through the use of group therapy of this kind, the client has the opportunity to improve his or her relationships with others and with himself or herself. In other words, this type of group gives clients the opportunity to become conscious of the interaction between social comparison, social identity,...

Step Two Be Clear About Your Definition of Spirituality and Religion

The therapist must next give considerable thought to his or her understanding of the meanings of spirituality and religion that he or she will use to describe these phenomena to group members. I read widely and choose to define terms for my patients in ways that are inclusive without being imprecise. Definitions That Meet These Criteria Spirituality encompasses a search for meaning, for unity, for connectedness, for transcendence, and for the highest of human potential. Religion is a (more or...

Your Bodyyourself Draw Your Body And Explore Your Selfimage

Psychodynamic-oriented group psychotherapists (Rutan & Stone, 2000) usually encourage verbal interaction in the group and work with words, not with action or art materials (Malchiodi, 1998). When they do use planned active interventions they find it hard to incorporate these techniques into their regular group process. The following technique is used to enhance body awareness (Cash & Pruzinsky, 2002), but also to deepen exploration of self-image. It is used not as a stand-alone technique,...

Using Dreams in Group Therapy

DIFFERENTIATING BETWEEN DREAMING AND DREAMTELLING AND THREE WAYS TO APPROACH DREAMS A dream told in a group has a strong impact on its working culture, openness, trust, and deepens the understanding of individual and social unconscious processes. Although dreaming may be highly influenced by interpersonal stimuli, it is an autonomous, intra-psychic function. Dreamtelling is a social event, making it especially interesting in groups. Questions like To whom do we tell a dream and why What is...

Integrating Social Justice Into Group Therapy

Amongst virtually every mental health discipline, the call is going out for integrating social justice into practice. Many fields such as psychology, counseling, and social work are imploring practitioners to take seriously the task of addressing inequalities and injustices faced by their clientele. As Prilleltensky, Dokecki, Frieden and Wang. (2007) eloquently stated, if we don't challenge the status quo, we tacitly support it, and if we concentrate exclusively on intrapsychic dynamics, we run...

Modeling a Nondefensive and Empathie Acceptance of Group Resistance in a School Based Anger

Management Group with Urban Adolescents 237 Other People's Children 237 Goals of the Group and Group Composition 237 Chapter 46. Saying Goodbye A Termination Ritual 243 Description of the Intervention 244 Chapter 48. Using the Group Power for Interpretation 255 A Personal Style of Intervention 255 Clients' Responses to the Intervention Conclusion and Contraindications Chapter 49. The Values Auction 259 Conclusion and Contraindications 261 Chapter 50. Individual Psychotherapy in the Context of a...

Client Responses

When initially presenting the task to the group, the members tended to flood the leaders with questions about how to complete the task. Withholding specific answers caused a certain degree of stress, but after a couple of minutes the group understood the idea and started working. In our case the task led to a heated debate between a few of the members. Some took very active roles, others seemed not to be able to find their own voice unless asked directly by another group member, and quite a few...

Checklist For Starting A Group

The literature is ripe with information about how to conduct group psychotherapy. There are many approaches to this work and the interested reader has many choices for basic instruction of how to do this work (Berg, Landreth, & Fall, 2006 Bernard & MacKenzie, 1994 Fehr, 2003 Price, Hescheles, & Price 1999 Rutan & Stone, 1993 Trotzer, 2006). This intervention uses a checklist as a tool to determine if you are ready to have the first meeting of your new group. So often, therapy groups...

Conclusion On Group Therapy

In conclusion, this particular technique is very effective for providing feeling work, catharsis, (especially for grief work), and the opportunity for the client to realize that the client is not alone, (Yalom, 1975). It allows for feelings to be expressed, acknowledged, and honored. It is part of the healing work or original pain work (Bradshaw, 1988). individual Psychotherapy in the Context of a Group An Intervention 267 Individual experiential psychotherapy must be handled and utilized...

Changing Chairs Experiential Exercise for Exploration of Interpersonal

Conclusion and Contraindication 470 Chapter 87. Surfing an Unexpected Group's Tide 473 Sex Offender Client Population 473 Conclusion and Contraindication 475 Chapter 88. Mindfulness in Group Psychotherapy 477 Short- and Long-Term Group Populations 478 Guidelines for Intervention 479 Chapter 89. Zoom 483 A Quick Way to Get a Group Playing Together 483 Guidelines for Intervention 484 Conclusion and Contraindications 485

Resistance And Counterresistance In The Group Setting

A young-adult analytic group receives a new member, Lucy. After a while, two members leave the group almost at the same time and two new ones join the group. Lucy withdraws with the arrival of these two new members and when faced with experiences discussed in the group, Lucy deeply resents the situation, as she cannot identify with the problems brought in by the other members. She starts to miss sessions and her absence becomes the main topic of several sessions since other members take her no...

The Unconscious Process Of Identification

A process group is often about countering or disconfirming a patient's negative identifications and encouraging the individual to speak with his or her own true voice. Group therapy helps the patient do this in a number of ways including exploration of the negative identification, confrontation of the identification, providing new sources of identification, and by encouraging the patient to gain healthier identifications (Rutan & Stone, 2001). McWilliams (1994) writes that it is the capacity...

Responses To The Intervention

The response of both the client and the group to this particular intervention was perceived according to each member's own history. Some shed their own tears others sat in silence caught up in their own memories and thoughts. I asked the client to look around the room at the faces of all the others. I asked her if she wanted some feedback. She observed their empathy and sensitivity to her pain. I asked her to first state her own feelings about what had just occurred. She described her...

Conclusion And Contraindications

Obviously, there are powerful humanitarian reasons to try to help the traumatized as soon as practicable. This is especially so in the case of the major disasters. Nevertheless, the fact remains that the majority of people who experience traumatic or critical incidents recover within four to six weeks. Therefore, in most cases, early intervention is either uncalled for or is likely to be counter-productive. It is a psychological process that is akin to grief in that it is a normal human...

Presented Issue

A client disclosed sadly that her cat of fourteen years had suddenly passed away. Over the weeks, she had revealed that a new relationship had usurped her time with her pet, as all her available time after work had been dedicated to developing this new romance, leaving little time and attention for her animal. This client holds a high professional position. Her job is demanding, quite often she keeps longer hours than her staff. Due to the pressure of the job and her new boyfriend, the cat was...

The Intervention

I began with the use of guided imagery, (Bandler & Grinder, 1975 Bradshaw 1988), and asked the client to close her eyes and go to the last time things were well with her cat and her. I had her visualize that moment. In only seconds, the tears flowed. I asked her to tell her pet that this would be the last time they would be together. The group watched in awe as her state transformed into one of deep grief. Her head held in her hand, she began to weep. I prompted her to tell him whatever she...

The Group Therapist As Storyteller

Storytelling reveals meaning without committing the error of defining it. MAKING UNCONSCIOUS AMBIVALENCE CONSCIOUS In my view, one important function of the group is the education and acculturation of its members, in order to achieve a level of psychological sophistication where they can identify the psychody-namics of their fellow members and themselves. My own orientation is eclectic and psychodynamic. Like most of us, when I began training, I received a psychoanalytic background, which has...

Equality In Human Relations

For many individuals, group therapy provides special skills to deal with problems in social situations. Among the difficulties experienced by clients is the inability to ask for acknowledgment of their personal rights and needs. The foundation of this problem may be a resistance to express both positive and negative feelings, a lack of confidence to be direct, and a judgment that their requests are unreasonable and unacceptable to others. Alberti and Emmons (1990) suggest that Assertive...

Contraindications And Recommendations

The I's can be used in all situations from group therapy to everyday communication. The more practice I as a therapist have in utilizing this technique in my life, the greater my skill in applying the concept in my group communication. With even more practice, in highly charged emotional moments, I can assist the group more effectively. Very quickly, as therapists, we can discover the shift in thinking and expression provided with this technique. As therapists develop proficiency with using the...

Exploring Attachment in a Treatment Group for Men Who Batter

Programs for men who batter have proliferated in the last three decades, with ensuing debate on how to best treat this population. Researchers, practitioners, and activists have researched this population in an attempt to both explain why men resort to violence in their relationships and to devise effective treatment programs. Research suggests that shorter-term, structured treatment models presented simultaneously with court monitoring offer the most promise in reducing partner violence...

The Transitional Object

The concept of transitional objects to reinforce object constancy has been a long-established precedent in the study of child development and the psychodynamic model of psychotherapy (Baldwin, 1967 Stone & Church, 1973 Rutan & Stone, 2001). Yalom (1985) posited that in group psychotherapy, the individual client and or the group as a whole might view the therapist as a transitional object. In my groups, I often utilize a small, inanimate object to serve as a transitional object that ties...

Step Two Beginning the Ritual

The session opens with the therapist announcing that the group is saying goodbye to a peer that day. The therapist then takes out the rock and is the one who begins the ritual. It might go something like this TH Martha, one characteristic that made me choose this rock (holding it up for others to see) is that it is seemingly perfect, expect for this one tiny flaw. Yet, notice that the imperfection does not detract from the rock's beauty, but actually enhances it. We all know how you struggled...

Conclusion And Contraindication

This extraordinary group had taken me in and allowed me to share with them their grief in the place where their mourning took place. The members felt a greater connection to me the leader, and the cohesion of the group became even more intensified. The group members felt well understood and accepted by the leader, who never judged how they mourned or the timing of their grieving process. The contraindication in this intervention was in relation to me-the leader. In my decision to extend the...

Verbatim Patient Disclosure

The patient states I've left two messages for my daughter she doesn't call me back. I'm not surprised I was at a dinnerparty and the seat next to me remained empty no one likes me and it is always like that. TH Can you share with us why this means that no one likes you and why you generally feel that no one likes you PT That's just how I feel. When I don't get a call back it means no Multiple questions and statements are then asked and given by other patients in the group. My focus is toward...

Contraindications

During the assessment process, we need to be alert to our own responses Is this a person with whom you can imagine working, in a group Do you look forward to it If you are aware of anxiety or reluctance, what makes you imagine it will be different for others and for whom in particular One of the great benefits of groups is that they contain more resources than the therapist's alone, but it's neglectful to disregard our own feelings. If in doubt, give the assessment process a bit longer....

Diminishing Dissociative Experiences

For War Veterans in Group Therapy 217 Clients' Responses to the Intervention 219 Conclusion and Contraindications 219 Chapter 42.1 Am Part of the Group Matrix 221 Description of Group and Client Population 222 Description of Interventions 222 Typical Response to the Intervention 224 Conclusions and Contraindications 224 Chapter 43. To Err Is Human Turning Our Mistakes Chapter 44. The Ability to Verbalize One's Needs Clearly Patient's Statements Elicit the Type of Intervention 234

The Polite And The Not So Polite

I have the fortune or misfortune, depending on your perspective, to work with primarily very nice and gracious clients. However, that is not always an enviable position when trying to facilitate a group of highly passive and respectful adults in a psychodynamic psychotherapeutic group. The issues arise on how to encourage them to confront one another with honest feedback how to ask for honest feedback and expect to get it how to practice new behaviors like assertiveness or even some of their...

The Hot Seat

Early in my training in Gestalt therapy, I became acquainted with the dual-chair technique, originally introduced by Frederick (Fritz) Perls, founder of Gestalt therapy. I was struck by the versatility and power of this method, not only to increase self-awareness but also to promote interaction among group members (Glass, 2001). As originally practiced by Perls, an individual indicated his or her willingness to engage with the therapist by taking the hot seat, a chair facing the therapist. An...

Acceptance of Group Resistance in a School Based Anger Management Group with Urban Adolescents

Some call them other people's children (Delpit, 1995, p. 137). They are a unique clinical population not only because they are adolescents, but because many of them come from high-risk environments where extreme emotional reactivity is the norm. Gangs are prevalent in their urban neighborhoods. Some have seen family members shot in the street. When they come to school, some of them are ready and eager to learn, and appear to have made sense of the trauma that is part of their daily existence....

Dysfunctional Thought Record DTR or Automatic Thought Record

The classic psychodrama techniques of role reversal, doubling, self-presentation, interview in role reversal, mirroring, future projection, surplus reality, empty chair, and other action techniques (Moreno, 1934 Blatner 1996 Kellerman, 1992) can be applied directly to situations indicated in the DTRs. During the initial didactic sessions, we found that it is extremely helpful to teach the group members how to complete a DTR. It is important to introduce the DTR as a self-reflection strategy for...

Contributors To Group Therapy

Uri Amit, EdD, is a former chief psychologist (psychologist IV) at the Massachusetts Treatment Center for the Sexually Dangerous Persons, Bridgewater, Massachusetts. He is currently a senior clinician at the Ann Klein Forensic Center-Special Treatment Unit in Avenel, New Jersey. He is a diplomate of the American College of Forensic Examiners. Ainara Arnoso, PhD, Master in Group Analysis, is a teacher at the Department of Social Psychology and Methodology of CCC at the University of the Basque...

The Emotionally Disconnected Group

Expressing and working with emotions in the present moment of the group often represent a major challenge to people who are disconnected from their feelings and or acculturated to presenting a nice, accommodating stance in the presence of conflict. This reluctance to express so-called negative feelings is often closely associated with a suppression of body awareness and, therefore, little access to emotional awareness that can be stated in words. These disconnections can be bridged by the use...

Integrating Cognitive Behavioral with Psychodramatic Theory and Techniques

This brief chapter combines psychodrama and cognitive behavioral therapy (CBT) techniques in applied group settings. We illustrate the application of some CBT techniques that were found helpful in the three phases of psychodrama with college students and patients diagnosed with mood, substance abuse, anxiety, and personality disorders. Although both CBT and psychodrama models stress the discovery process through Socratic questioning, the use of certain structured CBT techniques (e.g., the...

Guidelines And Intervention For A Group Cognitive Behavioral Therapy Gcbt Psychodrama

In applying the various CBT techniques within the context of psy-chodrama, it is important to devote the first one or two sessions (at least three hours each) to educating the participants about the GCBT model (cognitive behavioral and psychodrama) to create a safe and secure environment in which individuals can share their concerns freely with group members. The initial didactic sessions convey the notion that the group format is, foremost, a problem-solving approach for working through...

Stress Inoculation Training

In 2004, Hurricane Ivan left its destructive wake through Florida's panhandle and the coastal regions of Alabama and Mississippi. Furthermore, due to the Global War on Terrorism operations and the storm's destruction of several military treatment facilities, I became the sole military psychologist providing psychosocial interventions for the region at Naval Hospital, Pensacola, Florida. To address the burgeoning and heterogeneous myriad of patients suffering from various anxiety disorders, I...

Bridging As a Tool to Avoid Scapegoating

A good scapegoat is nearly as welcomed as a solution to the problem. The concept of scapegoating, a unified dislike or hatred of one member by the majority of the group, is often misunderstood as a phenomenon that is done to a member of a group rather than a collusion between a group and a member's defensive patterns Gans, 1989 . The role of the scapegoat is often placed upon a group member by the remainder of the group as a way to disavow negative thoughts, feelings, or behaviors that they may...