1. Group Therapy

2.  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

3. Group Therapy First practiced at the beginning of the 20 th century by Joseph Pratt in Boston  Worked with tuberculosis patients

4. 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, self-help organizations (weight- control, AA, NA, etc.)

5. 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

6. Yalom’s Curative Factors  Common to most, if not all, group therapies  Sharing new information  Instilling hope  Universality  Altruism  Interpersonal learning  Recapitulation of the primary family  Group cohesiveness

7. 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

8. 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

9. Homogeneity vs. Heterogeneity  Major issue  Homogeneous membership – more direct focus on shared problems  Heterogeneous groups – easier to form, wider diversity (more like general society)

10. Marital & Family Therapy

11.  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.

12. 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

13. 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

14. 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

15. 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  Decreased fault-finding and blaming  Increasing mutual responsibility  Maintaining a here-and-now focus  Expression of preferences, rather than demands  Negotiating compromises

16. 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

17. 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

18. 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