Clientpatient Responses

Initially, we found clients/patients to be hesitant of the GCBT model. In contrast, once they are taught the basics of the automatic thought record and understand what an automatic thought is to them, they then realize this technique yields real-life data that are not terribly threatening. They show signs of relief and begin to see that auto-

made thinking is what "we" all do. In addition, they recognize "their" core beliefs and schémas in relation to "all" people across their life span, that negative situations activate schemas/core beliefs and this now has a calming effect. This knowledge serves to normalize the group cognitive behavioral therapy process allowing group members to feel at ease. Patients/clients have found this model useful in combination with individual therapy, either at the same time, or in sequence.

CONCLUSION

From our experience, integrating CBT with psychodramatic techniques creates a powerful and effective group process enabling participants to address problematic situations with the support of group members. Students and clinical populations respond well to the CBT techniques and find them helpful in becoming aware of their habitual dysfunctional thought patterns and beliefs systems that play an important role in mood regulation. Therapists can use advanced CBT and psychodramatic techniques, not illustrated in this brief chapter, to address intricate problematic situations. The basic and advanced cognitive behavioral coupled with schema-focused techniques merge nicely within the psychodramatic framework. Therapists can expect some resistance from group members, especially with regard to their not completing DTRs on time or their unwillingness to share their DTRs initially with the group. We found, however, that group members quickly begin to see the usefulness of the various structured CBT techniques and adapt accordingly.

One of the most important elements of GCBT is that it is data based—group members keep track of their dysfunctional thoughts, depression, anxiety, and helplessness scores from week to week. They are able to see changes that result from group therapy that make the therapeutic process a tractable one. The GCBT model promotes dynamic group interaction, experiential participation, provides opportunities for catharsis, and facilitates basic group psychotherapeutic techniques. The integration of CBT techniques allied to psychodrama help provide a balance between an exploration of emotionally laden situations and a more concrete, data-based, problem-solving process.

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