Curative Factors in Psychoeducational Groups

The applications of Yalom's "Curative Factors" to psychoeducational groups.

1. Curative Factors in
Psychoeducational Groups

2. Curative Factors in Psychoeducational Groups
Goal:
This presentation reviews the curative factors in
psychotherapeutic groups and their applications to
psychoeducational groups.
Self-check
At the end of this presentation there are 11 group
member statements to be matched to the identified
curative factors.

3. Curative factors in groups is a concept developed
by Irving Yalom and discussed in his books
Group Psychotherapy: Theory and Practice.
In different editions Yalom has made
some modifications to the original factors.
This presentation outlines the factors most applicable to
psychoeducational groups.

4. Not all the curative factors apply equally to
psychoeducational groups .
The importance of the factors may change over
time in a group or have greater importance in
some groups than others.
In this presentation the factors are rated as
primary, secondary and tertiary in terms of their
applicability to psychoeducational groups.
This rating system is not part of Yalom’s
discussion and review of the curative factors.

5. Imparting Information
The “Imparting of Information” occurs when group
members get useful in formation from either other group
members or the facilitator.
The imparting of information is not a factor Yalom identified
as a psychotherapeutic process. However he stated group
members felt it was very helpful to learn factual information
from other group members.
Primary Factor

6. Imparting Information in Psychoeducational Groups
This is the primary factor and purpose for psychoeducational
groups.
Each group focuses on specific learner outcomes that are either
new information or new skills.
Primary Factor

7. Universality
Most group practitioners and members state the sharing of
common experiences and feelings among group members
helps remove a group members’ sense of isolation, validate
their experiences.
Primary Factor

8. Universality in Psychoeducational Groups
Having members recognize common problems and experiences
is one of the building blocks of psychoeducational groups.
This acceptance of a common problem helps members feel not
alone in their experience and helps provide a common bond for
the members.
Most psychoeducational groups have a common theme
centered on a universal problem confronting all the group
members.
Primary Factor

9. Imitative behavior

Yalom and other group practitioners believe that group
members can develop social skills by observing and
imitating the therapist and other group members.
In traditional group therapies members can observe how
others managed conflict, supported one another or shared
feelings.
The group members then often model those same
behaviors latter in or outside the group.
Primary Factor

10. Imitative Behavior in Psychoeducational Groups
Having group members practice and demonstrate new skills is
one of the primary techniques used in psychoeducational
groups.
Imitative behavior is often the core of teaching any new skill.
One model for psychoeducational groups, “Skill Development”,
has the facilitator first demonstrating the skill, then members
practicing the skill and finally selected members modeling the
skill for the rest of the group.
Primary Factor

11. Instillation of Hope
The “Instillation of Hope” happens when group members
at various stages of recovery are inspired and encouraged
by other members who have overcome their problems and
are more successfully managing their lives.
Primary Factor

12. Instillation of Hope in Psychoeducational Groups
Psychoeducational groups focus on hope and reinforce the
concept that group members can successfully manage their
lives.
Some psychoeducational group programs have ex-group
members as co-facilitators.
All psychoeducational groups focus on providing new
information or skills that will help the members.
Primary Factor

13. Development of Socializing
Techniques
Traditional group psychotherapy is often viewed as a
learning lab where participants have opportunities to learn
and improve their social skills.
The safe and supportive group environment allows members
to take interpersonal risks and try new behaviors.

Secondary Factor

14. Many psychoeducational groups focus on developing social
skills.
When that is the specific topic of a group course then the
developing socializing techniques is a primary factor.
For many psychoeducational groups focusing on a variety of
topics such as “Getting Back into the Workforce” there is a
secondary gain of developing new social skills during the
group course.
Secondary Factor Development of Socializing
Techniques in Psychoeducational Groups

15. Secondary Factor
Curative Factor: Interpersonal learning
In traditional group psychotherapy there is a great emphasis
on members learning more about themselves and their style
of interacting with others.
Much group activity is spent on members exploring their
feelings and receiving feedback from others.

16. Interpersonal Learning in Psychoeducational Groups
Similar to developing social skills many psychoeducational
groups focus on increasing interpersonal learning. When that is
the specific topic of a group course then interpersonal learning.
And, similar to developing new social skills, psychoeducational
groups focusing on a variety of other topics such as “Budgeting
Your Money” there can be a secondary gain of interpersonal
learning during the group course.
Secondary Factor

17. Secondary Factor
Curative Factor: Existential Factors
In traditional group psychotherapy there is an emphasis on
individuals taking responsibility for their behaviors and the
consequences of their actions.
In many instances individuals come to therapy wanting to
learn how to change the world, where in reality the focus of
the therapy is how to change themselves and their reactions
to the word.

18. Existential Factors in Psychoeducational Groups
Part of the underlying message of psychoeducational groups is
that individuals are responsible for trying to manage their lives.
There may be factors out of the direct control of individuals but
the person is ultimately responsible for learning how to best to
cope and manage their life.
This does not discount the role of therapy, behavioral health
professionals and even chemotherapy. But it highlights the
primary role of the individual in managing their treatment
and their life.
Secondary Factor

19. Secondary Factor
Curative Factor: Guidance
Guidance is a factor that was identified in earlier research on
curative factors but was later discontinued. Yalom and other
practitioners argued that the facilitator often needed to be
directive in the group psychotherapy sessions.
They believed it was sometimes necessary to identify
members’ behaviors that were self-defeating and discuss
options for group members.

20. Guidance in Psychoeducational Groups
In psychoeducational groups the facilitator is also part
instructor and teacher.
In that role of teacher the facilitator gives clear feedback to
members on their behaviors.
The facilitator often models behaviors and certainly gives
corrective feedback to members on their performance.
Secondary Factor

21. Tertiary Factor
Curative Factor: Cohesiveness
Cohesiveness is defined as a phase of group development
when members feel trust, acceptance and belonging within
he group.
For Yalom and other group psychotherapists cohesiveness
is the primary therapeutic factor that is the base for all the
other factors.
In order for the group process to work and personal
development to occur the individual needs to be in a
cohesive group.

22. Cohesiveness in Psychoeducational Groups
Cohesiveness is an important factor in psychoeducational
groups because it provides a psychologically safe environment
where members are willing to take risks and try new behaviors.
However attaining cohesiveness is not a goal or focus of
psychoeducational groups. Members can learn new
information and skills in the absence of cohesiveness.
If the outcome of the psychoeducational group course has an
interpersonal focus then cohesiveness becomes a primary
factor.
Tertiary Factor

23. Tertiary Factor Catharsis
Catharsis is often described as an intense expression of
emotion leading to a sense of relief.
In group psychotherapy catharsis occurs when a member is
able to express their feelings or “tell their story” to the rest of
the group and feels a sense of support and acceptance.

24. Catharsis in Psychoeducational Groups
Catharsis is not often identified as a component of
psychoeducational groups.
Inevitably, there are time when members will feel overwhelmed
and need to experience this “catharsis”. When a member does
have a cathartic moment the facilitator needs to assist the
member, mobilize group support and process the event.
Tertiary Factor

25. Corrective recapitulation of the primary
family experience
In traditional group therapy members often relate to the
therapists and other members as parents and siblings. This
transference of emotions is often used by the therapists to
help members understand how the member’s relations with
family members impact on the member’s current
relationships.
The group therapist’s discussion of those themes can
help group members learn to avoid unconsciously repeating
unhelpful past interactive patterns in present-day
relationships
Tertiary Factor

26. The corrective recapitulation of the primary family group is
rarely a topic or issue for psychoeducational groups.
There may be times when members express forms of
transference to the therapists or other group members. If the
transference interferes with the learning then the behavior
needs to be addressed.
The interpretation of the behavior and direct discussion of the
transference is an issue for therapy more than
psychoeducational groups.
Corrective Recapitulation of the
Primary Family Experience in
Psychoeducational Groups

27. The curative factors discussed in this presentation can be
very useful to psychoeducational group facilitators.
These curative factors should be consciously integrated into
the design of psychoeducational group courses.
During the ongoing delivery of the psychoeducational
group sessions there will also be opportunities for the
facilitator to capitalize on the various factors such as
universality, instillation of hope or other factors.

28. He always wants all the attention from the facilitator
and does not want to share.
Maybe I am not as alone in my problems as I think.
That seems to be an interesting way to handle
that situation maybe it will work for me.
Look at how well George has done, I can do
that next time someone pressures me .
O.K. These are the four things to remember
when I go for my interview.
Maybe the facilitator is right and counting to five
will help cool things.
Universality
Catharsis
Interpersonal Learning
Cohesion
Family
Hope
Modeling
Guidance
Imparting Information
Imitative Behavior
Socializing Techniques
Match Member Statement to Factor
Curative Factor

29. I guess I needed to say that to everyone and
feel better now.
Maybe I do come across a little too hard on others.
This might be a chance to try something different..
Universality
Catharsis
Interpersonal Learning
Cohesion
Family
Hope
Modeling
Guidance
Imparting Information
Imitative Behavior
Socializing Techniques
Match Member Statement to Factor
Curative Factor
It feels good coming someplace where I feel
people accept me for who I am.
This not interrupting others when they talk is
tougher than it sounds.
Some of these other people have had it worse
than me and they are getting better.

30. He always wants all the attention from the facilitator
and does not want to share.
Maybe I am not as alone in my problems as I think.
That seems to be an interesting way to handle
that situation maybe it will work for me.
Look at how well George has done, I can do
that next time someone pressures me .
O.K. These are the four things to remember
when I go for my interview.
Maybe the facilitator is right and counting to five
will help cool things.
Universality
Family
Modeling
Guidance
Imparting Information
Imitative Behavior
Match Member Statement to Factor
Curative Factor

31. I guess I needed to say that to everyone and
feel better now.
Maybe I do come across a little too hard on others.
This might be a chance to try something different..
Catharsis
Interpersonal Learning
Cohesion
Hope
Socializing Techniques
Match Member Statement to Factor
Curative Factor
It feels good coming someplace where I feel
people accept me for who I am.
This not interrupting others when they talk is
tougher than it sounds.
Some of these other people have had it worse
than me and they are getting better.

32. The curative factors discussed in this
presentation can provide a positive
psychological environment for
helping members learn how to
successfully manage their lives.
Psychoeducational group facilitators
will greatly enhance their skills by a
thorough reading of Irving Yalom’s book Group
Psychotherapy: Theory and Practice.