A forty-year-old single woman who has been in the group for about three years was talking about the recent admission of her alcoholic brother to a rehabilitation facility. She spoke in length about her awareness that the rest of her family will not act honestly when they are called to a family treatment session as is required by the rehabilitation facility. She felt that she would need to take care of her family members by protecting them from having to face the truth about their own contribution to her brother's addiction. She was also worried about being attacked and isolated by her family if they felt too threatened by her approach to dealing with her brother's addiction issues. While she was talking, the rest of the group members were mostly quiet with occasional concrete suggestions as to how to respond to her family members.

Using the Group Poiverfor Interpretation

Therapist Intervention: A Four-Stage Process

Stage One: Seeking the Core Issue

It is the role of the therapist to be able to extract the core issue from the many words and feelings that the client(s) in group therapy disclose. In this case, one of the co-leaders asked her if she thought about her own needs and who will take care of her.

Stage Two: Clients Ponder But Are Often Interrupted by Other Group Members

She thought for a minute but was interrupted by a group member who wanted to give her advice as to how to deal with her family and she did not respond to the therapist's question.

Stage Three: Observation and Analysis of Group-As-a-Whole

As I observed the process I realized that the entire group was becoming numb and slowly fading away. I realized that the issue in the room was the inability to ask for one's own needs. The group members were all identified with the unparented child who needs to take care of his or her parents to make sure they will survive and to take care of himself or herself.

Stage Four: Appropriate Timing and Reframing the Interpretation to a Group-As-a-Whole Issue

At that point, I said that I am aware that everyone in the room is a caretaker and no one is allowing others to take care of them. That stopped the discussion and changed the process to focus on what makes it so difficult for the members to allow themselves to receive care, etc.

The timing of this interpretation was powerful because everyone was so busy focusing on the member who was talking about her family that they dropped their conscious defenses against their own difficulties in accepting support from others. During the rest of the session the members focused on being "trained caretakers" who are not comfortable in receiving care and their need to change this tendency.

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