Reflections on group psychotherapy

‘Family, group, and interactive therapies’ considers and describes the widely established practice of systemic family therapy, couples therapy, and group therapy, and also introduces psychodrama, art therapy, and music therapy, which are interactive therapies. Family therapy is often used when the referred patient is a child or adolescent. When families are struggling to find a healthy balance, systemic family therapy offers them an opportunity to take a step back and think together. Group therapy is traditionally composed of individuals with a range of problems—anxiety, depression, phobias, relationship difficulties. This range of problems and individuals makes the group a microcosm of ordinary life.

Through carefully choosing psychotherapeutic interventions based on treatment characteristics, we may increase the relatively small effect sizes for suicidal outcomes. This study aims to evaluate the efficacy of different psychotherapy formats in reducing suicidal ideation and attempts, including individual, group and family-based therapies, as well as combined modalities involving individual and group or individual and family interventions. We conducted a meta-analysis after systematically searching databases for randomised controlled trials up to April 1, 2024. Included studies targeted any mental health issue, were delivered in any setting, compared with any control group, and reported on suicidal ideation or attempts. Data extraction and quality assessment were performed independently by two researchers, and a mixed-effects model was used for data synthesis. One hundred and seventy-two studies were eligible, totalling 198 comparisons with a total of 22,440 participants. Individual therapy significantly reduced suicidal ideation (g = -0.33, p < 0.001, k = 72 comparisons), as did group therapy (g = -0.39, p < 0.001, k = 27 comparisons). For reducing suicide attempts, individual therapy (RR = 0.75, p < 0.001, k = 63 comparisons), and notably, combinations of individual with group (RR = 0.42, p = 0.010, k = 7 comparisons) and individual with family-based therapy (RR = 0.59, p = 0.041, k = 8 comparisons) were effective. Subgroup analysis showed that combined therapies were associated with larger effect sizes compared to single modalities in reducing suicide attempts (p < 0.001). This meta-analysis highlights that combined psychotherapy approaches, integrating individual sessions with group or family sessions, yields significantly higher effect sizes, reducing the risk of suicide attempts by 50%. These findings support the adoption of combined therapeutic strategies in clinical settings to effectively address suicidality. SUMMARY: Individual or group therapy is effective for reducing suicidal ideation. Family therapy seems less effective than other formats. Individual therapy, or combining individual therapy with group therapy or family therapy, is effective for preventing suicide attempts. A combination of individual therapy with group or family therapy seems more effective at preventing suicide attempts than other formats.

1. Ximena Sanchez-Samper, MD* 2. John R. Knight, MD* 1. *Center for Adolescent Substance Abuse Research, Children's Hospital Boston, Boston, Mass After completing this article, readers should be able to: 1. Discuss current trends in adolescent substance use and the specific substances used most commonly among 8th, 10th, and 12th graders. 2. Identify risk and protective factors, including genetic and environmental correlates, for the initiation of substance use in adolescents. 3. Discuss the most common concomitant mental health disorders and how they can affect the course of diagnosis and treatment for substance abuse. 4. Delineate the variety of treatment options available. 5. Describe the role of the pediatrician in educating patients and families on substance abuse prevention; performing screening and initial assessments; and providing support, brief counseling, or referrals for in-depth treatment. Adolescence is a time of physical, emotional, and psychological maturation as well as a period of searching for independence and experimentation. One area of experimentation associated with adolescence is substance use. (1) Although many adolescents experiment with drugs and alcohol from time to time without enduring problems, those who develop the disorders of substance abuse and dependence make substance use a major public health concern. The Monitoring the Future Study (MTFS) is a nationwide survey measuring smoking, drinking, and illicit drug use among nearly 50,000 8th, 10th, and 12th graders in more than 400 secondary schools in the United States each year. (2)(3) According to the 2006 overview of findings from the MTFS, approximately one fifth (21%) of today's 8th graders, more than one third (36%) of 10th graders, and nearly half (48%) of all 12th graders reported using an illicit drug at least once during their lifetimes. Despite a minimum legal age requirement to purchase alcohol, 6% of 8th graders, 19% of the 10th graders, and 30% of the 12th graders self-reported drunkenness during the month prior to being interviewed. (2)(3) Among the problems experienced by adolescents who use alcohol and drugs are …

Background There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer-term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho-educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

Background There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer-term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho-educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. The following recommendations are made.

The author examines contextual and process similarities and differences in group and family therapy, with emphasis on Yalom's group therapy and structural, strategic, and symbolic-experiential family therapy

Pharmacotherapy can improve some of the symptoms of schizophrenia but has limited effect on the social impairments that characterize the disorder and limit functioning and quality of life. Through computerized literature searches and bibliographies of published reports we identified peer reviewed studies of group, family, and individual therapy with schizophrenia and schizoaffective disorder patients. We identified 70 studies: 26 on group therapy, 18 on family therapy, and 11 on individual therapy. Additionally, treatment models were compared in 4 studies and combined in 11 others. Controls were included in 61 and all studies included medication. Benefits in symptoms as well as social and vocational functioning were associated with psychosocial treatments. Family therapy demonstrated the most promising findings and traditional social skills treatment yielded the least robust results. Adjunctive psychosocial treatments augment the benefits of pharmacotherapy and enhance functioning in psychotic disorders. Although these positive results have led to increased enthusiasm about psychosocial treatments for schizophrenia, questions remain about comparative benefits of specific treatment methods and additional benefits of multiple treatments.

Sibling therapy combines aspects from both group and family therapy, yet it offers treatment possibilities not available to either. Three similar concepts, goals, stages, and interventions are described, with clinical examples of each

Objective: To investigate the perceptions of senior psychiatric trainees regarding the extent and satisfaction of the teaching during psychiatric training of five different psychotherapies, namely cognitive behavioural therapy (CBT), dynamic therapy, family therapy, group therapy and supportive therapy. Method: A 60-item questionnaire was completed by 95 senior psychiatric trainees in Australia and New Zealand. This questionnaire used Likert scales to examine the degree of satisfaction in the quality of teaching received in the five psychotherapies. The teaching mostly consisted of seminars and supervision. Qualitative responses were also sought regarding the experience of teaching and suggestions for improvement. Results: Satisfaction rates in the quality of teaching varied from 7 to 41% and in the extent of teaching ranged from 4 to 20%. Trainees wished for more training in CBT, group, family and supportive therapies, practical seminars, and better supervision. Conclusions: Psychiatric trainees view the extent and quality of teaching in the psychotherapies as being deficient. Implications of these findings are discussed.

The Eastern Group Psychotherapy Society: Its Beginings Bernard Frankel1 issn 0362-4021 © 2015 Eastern Group Psychotherapy Society group, Vol. 39, No. 2, Summer 2015 103 1 Clinical Professor, Derner Instiute, Adelphi University Psychotherapy Training Programs. Correspondence should be addressed to Bernard Frankel, PhD, ABPP, LCSW, BCD, LFAGPA, One Morning Side Drive, Apt. 1714, New York, NY 10025. E-mail: BFBC@optonline.net. This year marks the 60th anniversary of the founding of the Eastern Group Psychotherapy Society (EGPS). As one of the few octogenarians still alive with an intact memory, I am pleased to write a brief article about the society’s early history. Most of my contemporaries are deceased, and only Herb Rabin is still alive. Originally born in 1955 and almost a clone of the American Group Psychotherapy Association (AGPA) in regard to parallel activity, the original EGPS became defunct after 12 years. For almost six years, EGPS held no meetings and only an occasional scientific event. No one was taking care of the store, and the presidency became an honorary (and meaningless) title. Some thought that AGPA, which until 1961 had had its annual conferences in New York City, was the more desirable place for (stepping up the ladder) national recognition. Others thought that EGPS was too intertwined with the Post-Graduate Center, the only training center for analytic group therapy at the time. What was missing was diversity and differentiation to breathe life into a dying organization. In 1968, along came Zanvel Liff, who began to meet with Max Siegel, of Brooklyn College (and president of the American Psychological Association), and me, from the Center for Group Psychoanalysis and Process. We were, though committed to group and family therapy, a diverse group. We organized an active board, and I had the task of organizing the first annual conference of EGPS with a great committee of famous names. We were off and running. As conference chair, I planned and implemented the first four conferences with some of my other octogenarians . The conferences were well attended, and our presenters were the who’s who of group and family therapy: Al Wolf, Helen Durkin, Henny Glatzer, Cliff Sager, 104 frankel Hy Spotnitz, Asya Kadis, Milton Berger, Harold Leopold, Betsy Mintz, and other luminaries whose names could fill a page. These were the outstanding clinicians, educators, and innovators of the time. Institute fees were no more than $30, and workshops were only $5 each. We were able to hire an administrative assistant, Ruth Marcus, who was with us for many years. We added a lot of money to fill an ample treasury and used to have a catered party for the entire EGPS membership at no charge. Who ever heard of presenter’s fees at that time? At one point we had more than $100,000 in the bank. Concurrently, there was a lot of excitement and experimentation about the growing humanistic movement in the therapies. Encounter group techniques were being tried, and we brought the leaders of gestalt therapy and transactional analysis to New York City for Friday-to-Sunday workshops. Subsequent conferences introduced family therapy with Peggy Papp and Phil Guerin. Family therapy became an important part of our learning environment for many years—but it is now diminished, unfortunately. One reason for this decline is the polarization of AGPA and the American Association of Marriage and Family Therapy into two separate and detached entities. Gone are the days when, at AGPA conferences, I would conduct family therapy demonstrations for 100 registrants. The idea of themes for conferences did not emerge until 1978, starting with “Narcissism in Group and Family Therapy” in EGPS. What a cast: Bergmann, Alger , Fieldsteel, Spotnitz, Guerin, Papp, and others. With themes, we were playing copycat with AGPA. Prior to the birth of the Annual Spring Event, which is about 12 years old, there was some attempt each April to have all-day training workshops in New York City, Westchester, and Nassau-Suffolk on Fridays and Saturdays, costing from $15 to $30. In addition, in 1977, we had an annual weekend of group supervision for group therapists at the fee of $50 for one day and $75 for two. What a bargain, with Al...

Family, Group, and Community Therapies, Group Therapy, Behavioural group therapy for obsessions and compulsions, Marriage Therapy in the 1970s, Treating Families of Delinquents with one Hand Tied Behind Your Back

Executive summaryBackground There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side‐effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy.Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy?Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one‐to‐one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo‐randomised controlled trials that address the use or comparison of these treatment modalities were included. High‐quality systematic reviews of evidence of effectiveness were also included.Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta‐analysis was not possible given the level of heterogeneity in trial methods and measurement scales.Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer‐term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho‐educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

DANIEL A. BOCHNER: The Therapist's Use of Self in Family Therapy. Jason Aronson, Northvale, NJ, 2000, 484 pp., $60.00, ISBN: 0-7657-0248-7. Countertransference (CT) is viewed by psychodynamic therapists as an obstruction to understanding the patient. Family therapy has paid little attention to it. The Therapists' Use of Self in Family Therapy, Bochner offers a metapsychology of the use of self. He does so by arguing that the therapist's emotional response to the patient's CT brings him or her into the family system and enhances an understanding of it. His definition of CT follows that of Winnicott who sees CT as due to therapist's unresolved conflicts or an unconscious aspect of the therapist's personality or as emotions that are a reaction to the patient. CT is viewed as informative and useful as well as problematical. Projective identification, as described by Kernberg, is said to be the glue of relationships and an important factor in CT. It connects intrapsychic dynamics to interpersonal behaviors. Bochner uses projective identification to connect intrapsychic and interpersonal dynamics. In family therapy, activity and self-disclosure are an inevitable consequence of the therapist's CT. Bochner, a clinical psychologist who does individual, family and group therapy, offers a of treatment that attempts to integrate the psychodynamic and interpersonal. He calls it a relational systems model (RSM). Following an introduction, the author uses two chapters to review the use of self in individual and in family therapy. In his fourth chapter, Bochner reviews the intersection between intrapsychic and dyadic systems in groups and families. Systems theorists disavowed psychoanalytic concepts. In place of insight, methods and action became paramount. All of this leads up to his sixth chapter, the metapsychology of the RSM and a seventh on the therapist's use of self. In the seventh chapter he gives vignettes from nine different family therapists to demonstrate how the interface between the family and therapist can be understood by focusing on therapist CT and the use of different kinds of interpretations. He categorizes various points of view in these therapies, such as the psychoanalytic/ object relations model, the structural model, the experiential view and an integrationalist view. Therapists following the psychoanalytic/object relations use self-reflection as a central component in their work. The integrationalist therapist acknowledges that the experiential aspect of therapy is essential to the full use of CT. The vignette from Scharf demonstrates how the interface between family and therapist can be understood through therapist CT. The therapist openly uses his own personality to formulate an intervention. The Slipp vignette uses both systemic and genetic interpretations, but Slipp doesn't think of himself as part of the family system. …

This study examined the multidimensional structure of the client and therapist versions of the self-report measure, System for Observing Family Therapy Alliances (SOFTA-s; Friedlander, Escudero, & Heatherington, Therapeutic alliances in couple and family therapy: An empirically informed guide to practice. Washington, DC: American Psychological Association, 2006) across three distinct therapeutic modalities (individual, family, group). Specifically, we investigated whether the originally theorized model of four first-order factors (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family) would be reflected in a second-order factor (Therapeutic Alliance). The sample included 105 therapists who worked with 858 clients (165 individuals, 233 families, and 43 groups) in several Spanish community agencies. To control for dependent data, we used multilevel modeling. Results of the multilevel confirmatory factor analyses showed adequate reliabilities, fit indices, and factor loadings across the three therapy contexts for both versions of the measure (client and therapist). Adequate measurement invariance was also found across respondents and therapy modalities. Taken together, these results support the structural validity of the SOFTA-s, a brief and flexible self-report alliance measure that can be used reliably in clinical practice as well as in studies of individual, family, and group therapy.