Group therapy

Group therapy

1. Group Therapy By Muhammad Musawar Ali MPHIL, ICAP

2. What is group therapy?

3. Group psychotherapy is a treatment of psychological problem in which two or more patients/client interact with each other on both an emotional & cognitive levels in the presences of one or more psychotherapists who serve as catalysts (the person who can be related to or who can understand the other’s point of view), facilitators or interpreters.

4. History Of Group Therapy

5. History of Groups Originally found successful in treating patients with TB in the early 1900’s Jacob L. Moreno introduced group therapy in counseling in 1920. Later used during WW II for treating those with emotional reactions

6. In 1946 “ T-groups ” emerged, to enhances interpersonal relationship. It was the beginning of modern group work. Encounter group- intended for “Normal Functioning” who wanted to grow . Marathon group- breakdown barriers that individuals use. The 1960 human potential movement “Founded on the belief that the most people only use a small percentage of their capability but that within a group experiences, they can recognize their full potential”.

7. Goals of group therapy

8. Help Individuals Identify Maladaptive Behavior Help with Emotional Difficulties through Feedback Offer a Supportive Environment

9. Types of group

10. Psychoeducational / Guidance group Counseling/Interpersonal Problem-Solving Groups Psychotherapy Groups Task/work Groups

11. Psychoeducational / Guidance group The purpose is to teach group participant how to deal with a potential threat (catching the flu), developmental life events (growing older) or immediate life crisis (death of love one) Used in educational setting but frequently used in hospital, mental health center, or social service agencies.

12. Counseling/Interpersonal Problem-Solving Groups These groups help participants resolve problems of living through interpersonal support and problem solving.

13. Psychotherapy Groups These groups focus on personality reconstruction or remediation of deep-seated psychological problems.

14. Task/work Groups A group that comes together to perform a task that has a concrete goal (e.g. community organizations, committees, planning groups, task force).

15. Stages of group development

16. Stages Of Group Development

17. How we conduct group therapy?

18. Guidelines for group therapy Maintain Confidentiality Commitment to Attendance. Socializing with Group Members Putting Feelings into Words Not Actions. Role of Leader and Members

19. Yalom’s Therapeutic Factors Yalom (1995) defined therapeutic factors as "the actual mechanisms of effecting change in the patient“. Yalom identified 11 factors that influence the processes of change and recovery among group therapy clients.

20. 11 Therapeutic Factors Universality - feeling of having problems similar to others, not alone Altruism - helping and supporting others Instillation of hope - encouragement that recovery is possible Guidance - nurturing support & assistance Imparting information - teaching about problem and recovery Developing social skills - learning new ways to talk about feelings, observations and concerns

21. Cont… 7) Interpersonal learning - finding out about themselves & others from the group 8) Cohesion - feeling of belonging to the group, valuing the group 9) Catharsis – release of emotional tension 10) Existential factors – life & death are realities 11) Imitative behavior – modeling another’s manners & recovery skills

22. Group Composition Homogenous groups Group composed of patients of the same age, race, sex, socioeconomic level and similar of illness.

23. Group Composition Heterogeneous groups Group vary on different clients age, race, sex, socioeconomic level and different category of illness.

24. Saima Noreen (08) M.Phil Clinical Psychology

25. Concerns in Group Work Group Size Group counseling and psychotherapy generally work best with 6-8 members. If group run as long as 6 months 10 people c an be included.

26. Cont … Length and Duration of Sessions G roup sessions range from 1-2 hours .

27. Cont … Group structure open (allows members to enter and leave the group as needed) closed ( only the group members who started at the beginning are in the group at the end).

28. Purposes of therapist intervention To help build an atmosphere of trust and safety. To enforce rules and norms. To provide feedback. To get a member’s input, reaction or feedback. To draw connections between members or point out themes. To correct irrational or faulty thinking. To empower participants. To offer support when needed. To reinforce helpful contributions. To encourage constructive risk taking .

29. Functions of group therapy Sharing experiences Support to & from group member Socialization Imitation International learning

30. Sharing experiences This help the client to realize that they are not isolated & that other also have similar experience & problem Hearing from other client that they shared experiences is often more convincing & helpful then reassurance from the therapist.

31. Support to & from group member The sharing action of being mutually supportive is an aspect of the group cohesiveness that can provide a sense of belonging for client feeling who feel isolated in their everyday lives.

32. Socialization It is acquisition of social skill (E.g. maintaining eye contact) with in a group through comments that member about one another deficiencies in social skills. This process can be helped by trying out new ways of interacting within the safety of the group.

33. Imitation It is learning from observing & adopting the behaviors of other group members. If the group is run well, client imitate the adaptive behaviors of other group members.

34. International learning It refers to learning about difficulties in relationships by examining the interaction of individuals with the other members of group.

35. Techniques of group therapy

36. Roles of Therapist An advisor An advocate A facilitator A social policeman A technician An enabler

37. Techniques of group therapy Cognitive therapy Focus on irrational thoughts and beliefs of members and restructuring perceptions and beliefs by substitution of new effective thoughts and beliefs.

38. Cont … Behavioral therapy Behavior is learned so ineffective behavior can be unlearned and replaced by effective behavior.

39. Cont … Role play One member of the group can portray someone in another group member's life to give the other member a chance at practicing how to communicate effectively.

40. Cont … Story Writing and Sharing Members write a story about themselves and their lives and then read it aloud for the group to hear and discuss. 

41. Cont … Task oriented groups To develop social skills ,interacting in a group home. Therapeutic activity groups Wide array of art, music, dance, psychodrama and many other techniques having a defined therapeutic goal.

42. Areas That May Particularly Benefit From A Group Therapy Addiction Anxiety Depression Obsessive Compulsive Disorder

43. Benefits of having co-therapists More expertise . Allows for division of labor (e.g. one leader can concentrate on content and the other leader can look at process variables ). Group members receive more individual attention. Two leaders can model communication and conflict resolution. Two leaders provide diversity in theoretical orientation, interpersonal style, and cultural resources.

44. Limitations/dangers of co-therapists If two leaders do not get along, it can be detrimental and even harmful to group Co-leaders might develop competition between themselves and this too is not good for the group If co-leaders have different skill levels , one might try to lead the other. This can lead to coalitions with other group members or even in the marginalization of the more inexperienced leader Group members might feel ganged up on if both leaders become adamant in getting across a therapeutic message

45. Advantages Y ou realize you’re not alone . F acilitates giving and receiving support . H elps you find your “voice .” Helps you relate to others (and yourself) in healthier ways . Social Skills Learn From Others Mistakes Diversity of Opinions It costs less

46. Disadvantages Limited Privacy Personality Clashing Loss of trust It strikes fear into some patients . It doesn’t guarantee confidentiality . Social Anxiety Mourning A Loss

47. Conclusion Group therapy plays a major role in rehabilitation of mentally ill client. It gives an opportunity for immediate feedback. It facilitates chance for therapist to observe the clients emotional and behavioral response towards variety of people. Enhances clients communication, decision making and assertive skill.