The Theory and Practice of Group Psychotherapy

The Theory and Practice of Group Psychotherapy

Introduction

In their descriptive book, Yalom Irvin and Leszcz Molyn presented their thoughts in 2008 on the subject group therapy. Their research has demonstrated that, group therapy is a strong venue for change and growth in that not only do clients receive adequate support, encouragement, and understanding from other people undergoing similar issues, but they also acquire different viewpoints, ideas, and perspectives on those problems. With this, this research is worth consideration in that it creates great insights on how group therapy experience is helpful to individuals. As argued by Irvin and Molyn (6), group therapy is applicable for a wide range of problems such as depression, anxiety, and sex abuse problems among others. Throughout their research, Irvin and Molyn have retained clinical observations and valid research to educate many about the effectiveness of group therapy.  Thus, this research seeks to explore the theory and practice of group psychotherapy.


Leadership of Psychotherapy Groups

According to Irvin and Molyn (9), group psychotherapy and counselling has been effective in solving various problems such as anxiety and depression. The most essential component linked to the effectiveness of the group therapy is leadership. Leadership plays a crucial role in the practice of group therapy in both the dynamics of the entire group and the outcomes of the patients. Effective group facilitation, various leader characteristics, and behaviours are usually linked to the effectiveness of group therapy. This section will start with an overview of the group leadership characteristics along with behaviours that provide benefits to the process and outcome of group therapy.

To Irvin and Molyn (9), the leadership of group psychotherapy sets a criterion for group counsellors to select a member whose goals and needs are compatible with those of the group members. The most procedure used to detect or decide whether a leader is appropriate for the group is evaluating whether the individual can effectively enhance the outcome of the group therapy. This implies that, instead of selecting leaders based on their specific personality characteristics that would boost the likelihood of the group members having the best group experience, an HIV patient would be referred to an HIV group. Having leaders in the group going through similar issues with other group members is important since they create a setting where meditation and mindfulness of the problem takes place. For instance, leaders for HIV patients offer considerable support and medical information, which is helpful for patients in that such support eradicate fears as well as misconception of the illness. In some instances, group therapists may advise members on the best diet to consider and how to avoid criticism from family members. Similarly, leaders of bereavement group may help clients about the natural scene of bereavement, which in turn, lessen the distress encountered by most people as they move through the cycle of bereavement. In other words, a group therapy in such a scenario would eradicate any distress experienced in anticipating why one feels the way he does during the season of bereavement.

Leaders of psychotherapy use different interventions and techniques to enhance the development and positive outcome of the therapeutic group. For instance, a structure is conveyed when a group leader is highlighting the rules and regulations of the group such the importance of attendance, what to do when absent, and emphasizing on the importance of interaction among each other. As argued by Irvin and Molyn (10), when group leaders perform their duties and effectively they enhance better outcomes of group psychotherapy. Group therapists guide clients on how to enter into the psychotherapy effectively without fear. With this in mind, group therapists prepare different sessions that emphasize on the importance of the group therapy. The leadership of the psychotherapy group confronts clients’ fear and anxieties by providing emotional and medical support and speaking openly about how to live a fulfilling life. Thus far, Irvin and Molyn support the argument that group leaders are important in enhancing development and a positive group. In facts, Yalom Irvin affirmed that group leaders have a critical role of creating a therapeutic group climate. In other words, it is the duty of the group leader to create a conducive environment for group interaction.

The Therapeutic Factors in Group Therapy

To Irvin and Molyn (1), there are various therapeutic factors that enhance therapeutic change in the group therapy. These factors have had a tremendous impact on the group therapists. The eleven factors include hope instillation, imparting information, universality, altruism, and the remedial recapitulation of the primary family group, the development of socializing technique, existential factors, catharsis, interpersonal learning, and group cohesiveness (Irvin and Molyn 1).

The first therapeutic aspect is hope instillation that highlights how the group facilitator should create a strong platform for clients to understand the benefits of the group therapy. When a client is optimistic that group therapy enhances healing, then he or she can be hopeful when going through the entire process. The therapist should help the client believes and feel optimistic about the therapeutic process. The second aspect is universality, which creates a strong ground for clients to understand that they are not isolated or alone despite having psychological issues. This simply means that, when a client is in a group setting amongst people with similar issues to him, it in turn enhances the healing process. At this point, Yalom Irvin believes that there is no deed or thought that is unique or weird to human experience. In other words, many individuals tend to suffer issues that many people have faced in the past. With this, this therapeutic factor obliges that there is the universality of human emotion and experience, which provides fulfilment and enhance the great healing process.

The third therapeutic factor is the passing of information also known as imparting information. This factor emphasizes that, group therapists should give clients advice, instruction or suggestion on how to cope with various issues. Yalom believes that “didactic instruction” and direct advice are powerful means of imparting information. This is because group therapists can directly educate clients on their illness and fruitless thought patterns, thus making them see the reality. Similarly, group therapists can educate clients on the importance of group therapy. Altruism is the fourth factor, which means helping or giving without expecting any return. Group therapy is the best venue and setting to exercise altruism in that a client has a chance to express his challenges and issues, which in turn, inspires and motivates other members to live a fulfilling life. Fifthly, the remedial recapitulation of the primary family group in, which Yalom emphasizes that most clients tend to be psychologically affected. With this, the group therapy is important for clients in that it helps them to relieve depression. The Group therapy is the best setting for clients to interact with their leaders and other people in similar situations or predicaments.

The sixth therapeutic factor is the development or advancement of socializing techniques, which occurs in the set up of group therapy. Therapy groups are vital since they enhance social skills development, which greatly help clients in their relationship and with others. The seventh factor is the imitative behaviour that highlights how group therapists teach other group members behaviours and communication patterns. Group therapies are important since they help clients to interact with other members and in the process they gather strength to go on in life regardless of any challenge they may face. For instance, when an HIV patient is amongst other patients he or she can effectively learn how to effectively cope with the illness. The eighth factor is interpersonal learning, emphasizing that relationships are important and the need for clients to belong is important. As clients interact with one another, they can get a chance to learn a lot in life.

 

The ninth factor is a catharsis that takes place when a person expresses his or her deepest feelings and in turn, this augments healing process. When there is a high level of cohesiveness in the group, other members can help a member who might be experiencing a difficult emotional experience. The tenth factor is existential, which is the ability to be with others in the group. This factor recognizes that life can be unjust and unfair when there is nowhere to run to for help. Through group therapy, an individual can live a fulfilling life without feeling depressed.

Group Cohesiveness

This is one of the eleventh therapeutic factors that allow members to feel comfort, love, and warmth of being part of the group. This factor is crucial in the healing process in that it creates a strong ground for clients to have a sense of belonging and feel unconditionally supported and accepted by the group members. Group cohesiveness is a crucial aspect in that it advances hope, self-esteem, and confidence. When group members feel attached to one another, they are in a better position to influence and support one another. With this, an individual feeling hopeless is likely to feel accepted and have a great sense of security.

The Therapist: Basic Tasks

In this section, this research explores the basic tasks or responsibilities of therapists and the techniques used to accomplish them. Before highlighting specific responsibilities and techniques, it is important to consider that a therapist should show concern, empathy, genuineness, and acceptance to the client. With this in mind, this paper will underline the techniques of the therapist in relation to three tasks, which are creating and maintaining the group, building a strong group culture, and activating along with illuminating the group.

First, a group leader is responsible for convening and creating the group. The therapist should identify and deter any force that may negatively affect the group. Continued absences, tardiness, sub grouping, and scapegoating threaten the successful functioning of the group and thus necessitate the intervention of the therapist. As a leader, a therapist should ensure that all group members adhere to norms and regulations of the group therapy such as total participation or attendance.

Secondly, the therapist should shape the group into the therapeutic system. Irvin and Molyn (121) argue that, that a therapist must build a strong culture that guide or facilitate effective interaction of the group. As mentioned earlier, a therapist must design norms that guide the group to build a strong culture. The therapist functions as the agent of change in that he directs and guide members on what to do and what not to do. In so doing, a group therapist builds a strong culture that gives forth therapeutic strengths. A therapist should create a favourable environment free from intimidation and insecurity. One of the most technically that a therapist might utilize to enhance a favourable environment is giving compliments and appreciations to group members.

The third task of a therapist is activating and illuminating the group. At this point, a therapist must help the group in designing and shaping the norms. In doing, he should employ various techniques to inspire the group to more in the desirable direction. Therapists should instruct and create awareness to clients about the rules and regulations of the group. They should reinforce the instructions and awareness in backing it with the high authority and present the benefit behind the suggested procedure. Typically, a therapist must create a conducive environment, which every member feels free to interact and air thoughts and comments.


The Therapist: Transference and Transparency

Having discussed the roles of the therapist and the techniques that assist therapists to accomplish the tasks, this section discusses what and how the therapist should be. According to Irvin and Molyn (121), any practice of group psychotherapy should start with transference that can either be a valuable tool or a set-back to the healing process. In his theory of psychotherapy, Freud highlighted various factors that enhance good relationships between therapists and clients (Irvin and Molyn 121). Although most relationships can be resolved easily, Freud noted that most bitterness and anger stem from deep sources of therapeutic work. With this, Freud defined this impediment as transference in that it consists of previous attitudes that might have been transferred to the client’s or patient’s life. When used properly, a therapist may enhance the healing process to a client with past pains or bitterness. For instance, if the client encountered problems such as lack of parental love when growing up, a therapist can give the client adequate love and attention. In so doing, this can assist the patient to fight and resist the past feelings. Therapists should understand that what the patient requires is not just an insight on what they are undergoing, but having a remarkable experience of being cared for, valued, and seen as important beings.

Typically, there have been controversial issues on how transparent a therapist should be. In response to this, Irvin and Molyn note that therapists should not disclose anything they are uncomfortable sharing about. However, therapists should focus on revealing about themselves in various ways such as voice inflection, dress code, body posture, and facial expression among others. A therapist should behave in a way that expresses concern and interest of the group rather than blaming or intimidating the client.

 

The selection of patients

Patients are usually selected through the clinical or medical judgement. In most cases, therapists select patients based on whether they are appropriate for the therapy presented such as the behaviour therapy or psychotherapy. This is done by analyzing the client’s medical history, which helps to understand the most suitable method of treatment. In this case, a psychiatric history, screening interview, and mental status of the patient can be helpful in the selection process for patients in group therapy.

The composition of Therapy Group

The best composition of therapy group consists of at least three members and a maximum of fifteen members. However, most therapists consider the composition size of 7-10 members to ensure effective interaction.

Problems faced in the group therapy

There are various problems faced in the group therapy such as group members who are too conservative or reserved and conflicts between group members. It is important to note that, group therapy is not suitable for patients with severe depression since they may be hard to manage in the group therapy setting.

Group Members Leading Group

There are different types of group members leading group. These include supportive groups, medication, self-help, and interpersonal group therapy. In the approach of supportive group, therapists ensure that the practices of group therapy are effectively used to enhance the well-being of patients. Self-help groups benefit group members in that, a group leader has an opportunity to express his personal experiences and give mutual support to people going through similar problems. Medication is one of the leading groups in group therapy in that it emphasizes on the need to educate patients about the importance of medication in the healing process. Lastly, interpersonal group therapy examines ways in which therapists may help clients such as overcoming drug addiction.

 

Works Cited

Yalom, Irvin D, and Molyn Leszcz. The Theory and Practice of Group Psychotherapy. New York: Basic Books, 2008. Print

 

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