Also, by being one of the first analysts to challenge the objective role of the therapist, he led the foundations for what was later referred to as intersubjectivity. In the meantime in Europe, Jacob Moreno was developing psychodrama through his Theater of Spontaneity in Vienna see chapter on psychodrama. In he introduced group psychotherapy into the American Psychiatric Association and it is quite probable that he coined the term group psychotherapy.
By the middle 30s Paul Ferdinand Schilder, an Austrian psychiatrist and psychoanalyst, was also laying the foundations of group psychotherapy; He was conducting group sessions with psychotic children in the Bellevue hospital in New York. The development of group psychotherapy as a practical method was largely atheoretical, but nevertheless was influenced by the study of group processes.
Gustav Le Bon was a major initial contributor. Le Bon dealt with the idea that a group is not a mere sum of its members and individuals tend to become more primitive once they join a large group, as they lose their sense of responsibility and their behaviors and feelings become contagious. It is self-evident that the events of WW1 provided thinkers with a field of study of human group dynamics. In this context, Sigmund Freud also studied group dynamics mostly in organized groups, such as armies and other types.
Also influenced by Le Bon, in he published Group Psychology and the Analysis of the Ego , where he highlighted that groups provide members with a sense of purpose and that individuals connect to each other through their relation to the leader, a father surrogate. Members must reduce their individuality to serve a common goal. In order to do this, they must replace their own ego ideal with that of the group.
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In order to re-acquire their individuality, they need to develop empathy. A practical shift in group psychotherapy occurred during WW2. Thus, he divided group processes into 2 types: The work group , where interactions represent a mature level of functioning and the basic assumption group , where modes of cognition are more primitive. During the same period, Siegmund H. Foulkes developed the idea of the group matrix, the network of direct communications within the group.
In , one of the major contributors in social psychology and group psychotherapy, Kurt Lewin, coined the term group dynamics , which refers to the way in which individuals and groups interact with their changing environment. The development of group psychotherapy in the 60s was mainly driven by financial factors; as the mental health centers in the USA were reaching their limits, group psychotherapy presented as an efficient psychotherapy method.
Also, psychotherapy in general was starting to gain acceptance as a method of personal development, rather than as a diagnosis-oriented method. This situation led to a vast popularization of group therapies and many groups were being led by minimally trained or unqualified leaders. Yalom, described certain therapeutic factors which come into place within the here-and-now context of the group and studied the group process. His 11 therapeutic factors became the basis of future group psychotherapy research.
Since the s, the development of brief models of psychotherapy also affected the groups. Closed-ended groups Brabender, , inpatient groups Yalom, were developed, while short-term models for specific homogenous groups started to gain acceptance. Relational psychoanalysis was developed as an evolution of object relations theory in the 80s Atwood, Storolow and found application in group therapy, by utilizing the concept of intersubjectivity. During recent years, previous models have evolved and the current trend involves research and evidence based therapy. A major effort in dealing with the long-term problem of unqualified group psychotherapy took place in with the foundation of the International Board for Certification of Group Psychotherapists within the AGPA, which requires a core curriculum to provide the Certified Group Psychotherapist title CGP.
Nowadays, major world events such as war, trauma and immigration have influenced group and intergroup dynamics, cultural and racial compositions and arrangements and thus they have become once again a major area of study in group psychotherapy. Evidence-based group therapies have been developed for trauma, as well as numerous other conditions. Group psychotherapy is an ever-advancing field, responding to social change and science developments and it does so by viewing the world through a peculiar lens: the group.
Since there are numerous models of group psychotherapy, the indications are virtually endless. Some models are indication-oriented, while others are not and can cover diverse fields, e. Regardless of the model, there are some variations within group therapy that should be noted. There can be many types of groups and the configuration can depend on many factors: Time, theoretical model, goals, composition e.
The major distinction for practical application is the time-limited and open-ended group. In time-limited groups, the duration of therapy can vary from 10 weeks up to years. These groups usually do not accept new members after initiation closed groups , have specific goals and are usually homogenous in composition. They can be groups for life issues, general medical disease, specific diagnoses, etc. Open-ended groups are usually more heterogenous and diverse, in an attempt to represent social diversity as effectively as possible. These groups are usually more explorative and less goal-oriented.
How does group psychotherapy work? This is a subject which has been extensively studied by many authors and many theories have been formulated. To create a frame of optimism increasing the belief and confidence that recovery is possible. The main goal of this factor is to engage the patients into the group process, by understanding the therapeutic potential of the group. The understanding that patients are not alone in their problems and their thoughts, feelings and behaviors can be similar to those expressed by others.
To educate and empower group members with important knowledge about their specific problem and about recovery. This information can be relayed in the form of psychoeducation or direct advice by the leaders, or even better, by other group members. Group members gain a sense of value by helping and supporting others and they learn to receive help. The group setting can be experienced as a reenactment of the primary family setting, where the dysfunctional patterns or roles one played in primary family can be identified and transformed.
The group, left alone to interact, will eventually become a model of society. This concept is defined as a social microcosm. The interpersonal interactions within the safety of the group setting encourage members to gain insight into their own interpersonal behavior, into how they experience others and into how others experience their own behavior and feelings. This learning model is facilitated through the corrective emotional experience : the combination of conceptual learning with an emotional experience and reality testing, as defined by Franz Alexander.
Cohesiveness is both a factor as well as a prerequisite for other factors to work. It consists of the concept of attractiveness how attractive is the group to the member and the concept of belonging, being valued and valuing others. Cohesiveness is an analog to the therapeutical relationship in individual therapy. A release of emotion that brings new insights into behavior or situations.
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Catharsis is not effective without cohesiveness, which creates a safe environment and allows emotions to gain meaning and context within the group. Group psychotherapy deals with interpersonal distress and its reciprocal relationship with individual psychopathology. The core theoretical principle in interpersonal group psychotherapy is that psychological disturbance is a consequence of disturbed interpersonal relationships and is manifested in disturbed interpersonal communication Leszcz, It is type of therapy where the main focus is the interpersonal communication between members.
This model has been developed by I. Yalom and Molyn Leszcz. This situation, where the concept of others is dictated by past experience, is called parataxic distortion and individuals address their behavior towards the fictious personality, rather than the real one Sullivan, This concept resembles transference and, in turn, can lead to maladaptive or adaptive and predictable responses and ultimately into a maladaptive interpersonal cycle.
The ultimate goal of an interpersonal group would be to bring these interactions into light in the here-and-now of the group, in order to promote interpersonal learning. The group becomes a social microcosm, where individuals come as they are. Interpersonal group therapists can understand the group process that is taking place, they are aware of transference and countertransference and can provide empathetic feedback.
Gradually, group therapists can catalyze the conversion of maladaptive interpersonal communication into adaptive, self-fulfilling relationships.
The Wiley-Blackwell Handbook of Group Psychotherapy
Although interpersonal learning is the core therepautic factor, it requires a strong level of cohesion in order to function. Interpersonal groups can be formed based on a vast array of characteristics e. Group members usually go through preliminary interviews which sometimes could include psychometric evaluation tools.
The goal of the initial evaluation is to screen and to prepare members based on principals of group formation. A good enough preparation usually has a favourable impact on group cohesion and on goal setting. Once the group is initiated, it goes through several developmental stages, where the therapists function accordingly. In conclusion, Interpersonal Group Psychotherapy is a model where group members form therapeutic relationships in order to understand their pathogenic interpersonal behavior and beliefs and these relationships are orchestrated by the leader, who promotes this emotional communication through feedback and empathetic listening within the here and now setting of the group.
Intersubjective and relational theory examines how each side of a relationship affect each other as well as the relationship itself. The relational model is a combination of depth psychology with attention to early developmental phenomena and unconscious dynamics with sensitive attunement to the here- and -now and the mutual, reciprocal, nature of human interaction. The basic context is that the psychoanalytic data are mutually generated by therapist and patients, co- determined by their conscious and unconscious activities in reciprocally interacting subjective worlds.
In relational-intersubjective model, it is essential, that the therapist has his own subjective perceptions and developmental history and these are part of his function both as a therapist and as a co-participant in the group. Group members form valid and significant insights of his personality and psychology and respond accordingly to them.
In other words, in relational group therapy, transference and countertransference always occur together. Group analysis matured from theory of group behaviour by Siegmund H. Foulkes in the first half of the 20th century. It uses theory mostly from psychoanalysis but also from system theory, developmental psychology and sociology. Conscious and unconscious processes is unfolded both in the individual and in the whole group.