Chapter 10: Creation of the Group: Place, Time, Size, Preparation The Theory and Practice of Group Psychotherapy Irvin Yalom, Ph.D.

Policy about the Lifespan of the Group Open or Closed Group Closed group - accepts no new members and usually is time limited Can be long term but you would need a captive audience Open group – accepts new members in order to sustain a consistent size

Policy about the Lifespan of the Group Duration and Frequency General principle is that the larger the group the longer time necessary. 6-10 members generally 60-90 minutes Frequency is usually once a week, but twice a week can be more intensive because the themes can be carried over better.

Policy about the Lifespan of the Group Then there are the Time Extended Group or Marathon Group Has anyone in the class participated in such a group? 1960-1970’s groups which experimented with the variable of time and its effects on inhibitions, defense mechanisms, disclosure and cohesiveness. There was a claim that the social microcosm effect developed more quickly.

Policy about the Lifespan of the Group During this time, the mass media presented these groups as being equivalent to several years of therapy. These groups produced affect laden experiences, however they may not generalize to other life experiences in general. It was also considered state learning, however you need to be in the state to generalize.

Policy about the Lifespan of the Group In Yalom’s experience, he with colleagues noticed that there were no measurable effects on the process of individual therapy. Hence, the generalizing/ transfer of learning requires an irreducible amount of time – relapse cycle – hard wiring

Policy about the Lifespan of the Group Brief Group Therapy The most common of groups In one study, only 8% of a long term group attended for the duration of the group which lasted 1 year. These groups: Strive for efficiency Set and pursue goals Present oriented Focus more on interpersonal than intrapersonal Homogeneous for a problem

Policy about the Lifespan of the Group Brief Groups : Aren’t truncated groups Goals must be clarified Brief groups are less forgiving of errors than long term groups. The leader needs to keep group focused because they can tend to deny their limits. Must keep time limitations in the forefront like Carl Rogers Must focus on getting pts to transfer their learning. Research on brief group is limited.

Group Size In studies with four or fewer members resulted with the following conclusions: Limited interaction Passivity Negative group image Poor group development Groups should begin with a larger group in order to account for dropouts.

Preparation According to Yalom, the more a pt is seen prior to group the less % for premature termination. This builds the therapeutic alliance. It uses the therapist as a transitional object (the mutual identification with a shared object). It decreases misconceptions leading to increased willingness and possibly motivation.

Preparation Rationale Behind of Preparation Unavoidable anxiety

Preparation “The research findings on preparation, though not as secure and specific as we might hope, are nonetheless significant. We have substantial evidence from a variety of sources that indicates that pregroup training can have a significant effect on both group process and client outcomes.”

Preparation A study in which 60 patients were observed. Half were prepared = more faith in therapy, more interaction Other studies show that preparation= more expressed emotion, more personal responsibility in group and lower drop out, more disclosure, work oriented participation, more popular to others in group,etc etc