Early Group Stages

In this stage, give a cognitive explanation. Don't challenge "we" or "the group" at this point.


Sarah continues to introduce herself to the group in the second session by saying, "You know, it's really scary to meet new people and wake up at night wondering what they thought of you."

THERAPIST: I imagine that you're speaking about your own experience after last week's group. SARAH: Yes.

THERAPIST: Well, I want to point out that people will understand you better if you are really clear with what you say so that when you're talking about yourself, you use the word I.

SARAH: Well, I was really scared. In fact, I'm pretty shaky right now. (Others respond with resonating and empathetic comments.)

Middle Group Stages

In this stage, briefly point out verbiage.


MARK: When Sarah said she was afraid of me, it felt frustrating—just like those times when my wife cringes away from me when I raise my voice.

THERAPIST: "It doesn't feel anything-did you feel frustrated?" Mark sounding more irritated: "Yes, I felt frustrated. I feel like no one listens and tries to understand what I'm angry about in the first place."

THERAPIST: "So look at Sarah and tell her about your experience." (Be ready to intervene so that first-person pronouns are used).

Advanced Group Stages

In this stage, be alert for one-word pointers, or, if pattern persists, ask client to look at his or her resistance.


DIANE: You feel so bad you just don't want to get out of bed? THERAPIST: Who?

DIANE: "/ feel so bad. It's hard for me to get anything done. It just feels better when you're lying there in bed and letting the world go by."

THERAPIST: "I notice how you're choosing to be passive in the very way that you talk about your passivity. What do you make of that?" DIANE: "It feels out of my control. The depression just takes over." THERAPIST: "I have a hunch that if you let yourself talk more directly about your experience you might have more feelings." DIANE: "I'm scared of feeling out of control!"

Other words to watch for:

• "You" (no pronoun/everyone/no one): Is there somebody feeling/ doing this? Who?

• "Make feel": Challenge this-can someone really make you feel something?

• "I think I felt": Why are they thinking/guessing about what they felt? Could they have a more immediate experience?

• Passive voice construction: e.g. "Yesterday there was a drinking binge." "The yelling got really out of control." Who drank? Who yelled?

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