Group Therapy
Group Therapy
 More than simultaneous treatment for
several individuals
 Advantages of group therapy:
 Economy: group therapy is less expensive
 Group support: there is comfort in knowing
that others have similar problems
 Feedback: group members learn from each
other
 Behavioral rehearsal: group members can
role-play the activities of the key persons in a
member’s life
Group Therapy
First practiced at the beginning of the 20th
century by Joseph Pratt in Boston
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Worked with tuberculosis patients
Group Therapy
 Use stimulated by the shortage of trained
therapists after WWII
 Every major model of clinical psychology
offers group therapy
also popular with nonprofessional,
selfhelp organizations (weightcontrol, AA, NA, etc.)
Group Therapy
 No consensus as to a uniform process of
group therapy
 Most therapists emphasize the importance
of interpersonal relationships and assume
that personal maladjustment involves
difficulties with interpersonal relationships
Yalom’s Curative Factors
 Common to most, if not all, group therapies
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Sharing new information
Instilling hope
Universality
Altruism
Interpersonal learning
Recapitulation of the primary family
Group cohesiveness
The Practice of Group
Therapy
 Groups usually consist of 6-12 members
 If too small – lack of universality and
cohesiveness
 If too large – mechanical feedback, lack of
sensitivity
The Practice of Group
Therapy
 Duration
 May be on-going or time-limited
Each session usually lasts longer than
sessions in individual therapy – 2 hours is
common
Homogeneity vs.
Heterogeneity
 Major issue
 Homogeneous membership – more direct
focus on shared problems
 Heterogeneous groups – easier to form,
wider diversity (more like general society)
Marital & Family Therapy
Marital & Family Therapy
 Marital and family discord are 2 of the
most common problems encountered by
clinical psychologists
 Approximately 50% divorce rate
 Child abuse, adolescent suicide, runaways,
substance abuse, etc.
Marital Therapy
 Often called couples therapy due to
societal changes
 The client is the relationship, not the
individuals in that relationship
 the goal is to save the relationship
Marital Therapy
 MT can be preceded by, followed or
accompanied by individual
psychotherapy for one or both members,
or can stand alone
 Individual therapy is indicated when one
member is suffering from a problem
largely unrelated to the relationship
Marital Therapy
 The need for couples therapy usually
arises out of the conflicting expectations
and needs of the couple
 Common areas of conflict: sexual
satisfaction, personal autonomy,
communication, intimacy, money
management, fidelity, expression of
disagreement/hostility
Marital Therapy
 Common theme among marital therapists –
emphasis on problem solving: learning to work
together, communication and negotiation
 Changing not only the way a couple talks to
each other, but how they think about their
relationship
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Decreased fault-finding and blaming
Increasing mutual responsibility
Maintaining a here-and-now focus
Expression of preferences, rather than demands
Negotiating compromises
Family Therapy
 Similar to couples therapy, but evolved for
different reasons
 A number of therapists noticed that a number
of individuals who made significant
improvements in individual therapy or
institutional treatment often had a relapse
when they returned to their families – this led to
an emphasis on the family environment and
parent-child interactions as causes of
maladaptive behavior
Family Therapy
 The basic concepts of FT differ from individual therapy
 Grounded in systems theory
 Circular causality – events are inter-related and mutually
dependent
 Ecology – systems can only be understood as integrated
patterns, not component parts
 Subjectivity – there are no objective views of events, only
subjective perceptions filtered by the experiences of
perceivers in a system
 Homeostasis – the tendency of a family to act in ways that
maintain the family’s equilibrium or status quo
Family Therapy
 The therapeutic focus is on changing interactions
between/among family members with the goal of
improving the functioning of the family or the
functioning of individual members of the family
 The focus is initially on one family member – the
“identified patient” or scapegoat (typically an
adolescent, but not always)
 The therapist reframes the problem in terms of disturbed family
processes or faulty family communications
 Family members are encouraged to see their own
contributions to the family’s problems, as well as the positive
changes they can make