The changing contexts for training in group therapy

Abstract

This is a review of my experiences watching the group therapy scene in the Boston area. I entered the field over 43 years ago, grew along with it, saw it change, participated in promoting it, heard about it in supervision and consultation, and heard about it from my patients whom I was treating, who were group therapists. This is not a scientific survey, but it is perhaps more convincing because it is a personal, clinical finding. In reviewing these past 43 years of experience, I shall try to describe the context within which training occurs, the role of the trainer in group therapy, and the role of the trainees. During this time, the context has shifted from the freedom to experiment to specific predetermined programs, from an analytic context to a biological context, and these shifts have had their impact on how group therapy is done, experienced, and learned. I did not choose group therapy and had not heard about it when I entered my psychiatric residency. I stumbled across it in 1948 when I started residency training. I never even thought of treating psychotics, but I ended up in a hospital where my chief teacher, Elvin Semrad, was interested in psychoanalysis, the psychoanalytic psychotherapy of psychoses, and group therapy, which he had learned during his days in the army. My first exposure for training people for group therapy did not occur in a training group. I never was a member of a training group. We lived in a training group, all 18 medical staff as well as the psychologists and social workers who participated in this program. Every lunchtime and dinnertime was part of the group experience. Every staff meeting was conducted as a group. No matter what we were discussing, Semrad (Semrad & Day, 1971) focused on the underlying group dynamics as well as on the specific issues. He welcomed everybody's disagreements and agression, smiled, and encouraged us to work harder. I have not found many other chairmen or directors interested in doing that. People would come in and complain, rage, smash their fists on his desk, shout, do the sort of thing that would get one thrown out of any faculty nowadays, or surely would get one sent off to another psychiatrist, and Semrad welcomed it and then encouraged people to work harder. He encouraged everybody to write papers and wrote along with them. We were then the lords of a kingdom of 3,000 chronically sick people. We were encouraged to try any approach that we wanted.