group therapy: ancestors & group therapy: ancestors & cousinscousins 1905 – Joseph Pratt developed group therapy for tuberculosis 1905 – Joseph Pratt developed group therapy for tuberculosis

patients; group approaches evolved in the 1920’s & 30’s e.g. patients; group approaches evolved in the 1920’s & 30’s e.g. Adler, Lazell, Moreno, etcAdler, Lazell, Moreno, etc

22ndnd WW – increased need accelerated group therapy WW – increased need accelerated group therapy developmentdevelopment

1946 – Kurt Lewin & T (training) groups with a focus more on 1946 – Kurt Lewin & T (training) groups with a focus more on organizational development & educationorganizational development & education

1960’s & 1970’s the heyday of “encounter groups” and cross 1960’s & 1970’s the heyday of “encounter groups” and cross fertilisation with traditional group therapy – note earlier fuller fertilisation with traditional group therapy – note earlier fuller chapter on encounter groups from 1995 edition of Yalom’s book chapter on encounter groups from 1995 edition of Yalom’s book is freely viewable on the internet – go to is freely viewable on the internet – go to www.yalom.com/books/, click on , click on “The theory and practice of group psychotherapy”“The theory and practice of group psychotherapy” and and then, in the left column, click on then, in the left column, click on “encounter groups”“encounter groups”

classic encounter groups have largely come & gone but they classic encounter groups have largely come & gone but they have had a considerable influence on how group therapy has have had a considerable influence on how group therapy has developed – both in the huge multi-headed self-help movement developed – both in the huge multi-headed self-help movement and in the more traditional psychiatric/psychological and in the more traditional psychiatric/psychological environmentenvironment

Yalom I.D & Leszcz M. The theory and practice of group psychotherapy (5th ed). New York: Basic Books, 2005

screening, selection, & screening, selection, & orientationorientation

it’s a reasonable position to say that most people could it’s a reasonable position to say that most people could benefit from involvement in some kind of group – screening & benefit from involvement in some kind of group – screening & selection involve asking whether this person would benefit & selection involve asking whether this person would benefit & be able to tackle the therapeutic ‘tasks’ of this particular be able to tackle the therapeutic ‘tasks’ of this particular groupgroup

structured stress management groups and interpersonal structured stress management groups and interpersonal process groups are two major basic forms of group with process groups are two major basic forms of group with different tasks and relevance for different populationsdifferent tasks and relevance for different populations

understanding the challenges and likely beneficial facilitation understanding the challenges and likely beneficial facilitation styles for these two basic types of group can act as a good styles for these two basic types of group can act as a good jumping off point for adaptations that suit other group formsjumping off point for adaptations that suit other group forms

whatever the group type, helping the client understand the whatever the group type, helping the client understand the group’s relevance to their problems and orientating them to group’s relevance to their problems and orientating them to what success-ful participation is likely to involve, is usually what success-ful participation is likely to involve, is usually time very well spenttime very well spent

therapeutic factors in groups therapeutic factors in groups (yalom) (yalom)

group cohesivenessgroup cohesiveness

universalityuniversality

catharsiscatharsis

interpersonal learning interpersonal learning (output)(output)

family re-enactmentfamily re-enactment

guidanceguidance

altruismaltruism

interpersonal interpersonal learning (input)learning (input)

instillation of hopeinstillation of hope

identificationidentification

self-understandingself-understanding

existential factorsexistential factors

Typically interpersonal factors, catharsis and group Typically interpersonal factors, catharsis and group cohesiveness are rated very highly. There is considerable cohesiveness are rated very highly. There is considerable variation though – with the type of group studied, with how variation though – with the type of group studied, with how long the group has been meeting for, and with the long the group has been meeting for, and with the participant’s level of functioning and personality style. participant’s level of functioning and personality style.

major experiential group major experiential group researchresearch

210 stanford university students were randomized 210 stanford university students were randomized to groups and compared with 69 matched controlsto groups and compared with 69 matched controls

18 different groups for 30 hours over 12 weeks18 different groups for 30 hours over 12 weeks expert facilitators from 10 different schoolsexpert facilitators from 10 different schools

encounter/personal growth; gestalt; TA; sensory encounter/personal growth; gestalt; TA; sensory awareness; NTL group process training; psychodrama; awareness; NTL group process training; psychodrama; Synanon; psychoanalytic; marathon; encounter-tape Synanon; psychoanalytic; marathon; encounter-tape

assessment by participants, observers, group assessment by participants, observers, group leaders, significant others – during and at the end of leaders, significant others – during and at the end of the group, and also at six month follow-upthe group, and also at six month follow-up

“the most extensive controlled research inquiry into the effectiveness of groups”

leader assessment: methodsleader assessment: methodsall meetings were observed (and tape recorded) – all meetings were observed (and tape recorded) – trained raters analyzed and coded all leader trained raters analyzed and coded all leader behaviours/statements; participants also completed behaviours/statements; participants also completed questionnaires about the leaders questionnaires about the leaders the therapeutic school that the leader represented the therapeutic school that the leader represented (e.g. gestalt, psychodrama, transactional analysis, (e.g. gestalt, psychodrama, transactional analysis, etc) had very little bearing on their etc) had very little bearing on their behaviours/statements in the group behaviours/statements in the group factor analysis of what the leaders said and did factor analysis of what the leaders said and did highlighted four important leadership functions highlighted four important leadership functions which had clear and striking relationships to which had clear and striking relationships to outcome – these are emotional activation, caring, outcome – these are emotional activation, caring, meaning attribution & executive function meaning attribution & executive function

leader assessment: cluster leader assessment: cluster analysisanalysis

emotional activationemotional activationchallenging, confronting activity; intrusive challenging, confronting activity; intrusive modelling by personal risk taking and high self-modelling by personal risk taking and high self-disclosure disclosure

caringcaringoffering support, affection, praise, protection, offering support, affection, praise, protection, warmth, acceptance, genuineness, concern warmth, acceptance, genuineness, concern

meaning attributionmeaning attributionexplaining, clarifying, interpreting, providing explaining, clarifying, interpreting, providing a cognitive framework for change; translating a cognitive framework for change; translating feelings and experiences into ideas feelings and experiences into ideas

executive functionexecutive functionsetting limits, rules, norms, goals; managing time; setting limits, rules, norms, goals; managing time; pacing, stopping, interceding, suggesting pacing, stopping, interceding, suggesting proceduresprocedures

leader assessment: best leader assessment: best outcomesoutcomes

emotional activationemotional activationchallenging, confronting activity; intrusive challenging, confronting activity; intrusive modelling by personal risk taking and high self-modelling by personal risk taking and high self-disclosure disclosure

caringcaringoffering support, affection, praise, protection, offering support, affection, praise, protection, warmth, acceptance, genuineness, concern warmth, acceptance, genuineness, concern

meaning attributionmeaning attributionexplaining, clarifying, interpreting, providing explaining, clarifying, interpreting, providing a cognitive framework for change; translating a cognitive framework for change; translating feelings and experiences into ideas feelings and experiences into ideas

executive functionexecutive functionsetting limits, rules, norms, goals; managing time; setting limits, rules, norms, goals; managing time; pacing, stopping, interceding, suggesting pacing, stopping, interceding, suggesting proceduresprocedures

mod

erat

e

mod

erat

e

high

high

the cycle of engagement & the cycle of engagement & reflectionreflection

immerse in experiences (emotions & body)

reflect and learn from experiences

importance of meaning importance of meaning attributionattribution

at the end of each group meeting, participants at the end of each group meeting, participants were asked to report the most significant event were asked to report the most significant event of the session and the reason for its significanceof the session and the reason for its significance

participants who gained most from the groups participants who gained most from the groups were far more likely to report incidents were far more likely to report incidents involving cognitive integrationinvolving cognitive integration

this finding was particularly impressive and this finding was particularly impressive and unexpected when one considers the pervasive unexpected when one considers the pervasive anti-intellectual ethos of encounter group anti-intellectual ethos of encounter group cultureculture

to benefit most, it seems crucially important to both engage emotionally

& also to reflect

major experiential group major experiential group researchresearch

““In some groups, almost every In some groups, almost every member underwent some positive member underwent some positive

change with no one suffering injury; in change with no one suffering injury; in other groups, not a single member other groups, not a single member benefited, and one was fortunate to benefited, and one was fortunate to

remain unchanged.”remain unchanged.”

key finding:key finding:

the the learning circlelearning circle of of experienceexperience

genuine, personal experience

observation and reflection time

testing implications

in new situations

forming ideas& generalizations

Kurt Lewin’s modelof experiential learning

note particular importance of here-&-now concrete experience in generating & testing out ideas, & also the importance of the feedback loop in checking whether one is really on track; ineffectiveness is often due to an imbalance between active

experience & reflective observation