Group Therapy Model Research Articles

Remembering the Forgotten: Psychotherapy Groups for the Nursing Home Resident

The mental health needs of the long–term nursing home resident receive little attention. It is especially difficult for the more cognitively intact resident to obtain psychological help. An integrated group psychotherapy model that incorporates developmental, cognitive–behavioral, and psychodynamic approaches is described, based on the author’s clinical experience in developing and co–leading four groups in three long–term care facilities over a period of ten years. The technical and countertransference challenges of working with this unique population and in this format are described, along with clinical material to illustrate common themes. The success of the groups in improving the morale, sense of community, and quality of life for group members is demonstrated.

Group Analysis and the Affective Disorders

In 1988, a Special Section on Group Therapy with Affective Disorders was published in the March issue of Group Analysis. An authoritative review supported the optimism of group therapies for depression. In general, group treatments compare favourably to individual psychotherapy, though the conclusion was that no one form or model of group therapy has great advantage over others. In this article, I shall discuss the nature of depression, the therapeutic aims of the group-analytic approach and attempt a group-analytic typology of depression. I shall then present some observations based on patients with bipolar affective disorders with whom I have worked in group-analytic and couples therapy.

A community model of group therapy for the older patients with chronic obstructive pulmonary disease: a pilot study

A community-based programme for chronic obstructive pulmonary disease (COPD) patients in group sessions is designed, and the feasibility, acceptability and physical and psychosocial outcomes evaluated. Patients with COPD discharged from hospital, or those attending specialist outpatient clinic, with a history of hospital admission owing to COPD in the preceding 12 months were recruited. Those who had malignancy or were housebound were excluded. Group sessions were arranged once a week in a Community Centre, and consisted of two hourly sessions. The components of each session consist of education regarding the disease, breathing techniques, use of oxygen and other medication, smoking cessation, nutrition, dyspnoea management skills, relaxation and energy conservation techniques, introduction of social and community support, and strengthening as well as aerobic exercises. Assessments before and after intervention include lung function, 6 minutes walk test (6MWT), general Health Questionnaire (GHQ), the St. George's Respiratory Questionnaire (SGRQ), and a COPD knowledge Questionnaire. A programme evaluation was carried out using questionnaire and group discussions. Forty-four subjects were recruited, with 75% completing the programme, and 20% with drawing for unavoidable reasons. Statistically significant improvement was noted in all domains of the GHQ, SGRQ, and knowledge test, while the mean 6MWT improved, although statistical significance was not reached. Subjects were enthusiastic about the provision of this service in helping them cope with the disease through empowerment and mutual support. A group community intervention programme for COPD patients is feasible and acceptable, with positive psychosocial outcomes. Such a model could be further developed and cost-effectiveness evaluated as a model of chronic disease management in the community.

Cognitive Predictors of Response to Treatment for Depression in Multiple Sclerosis

Cognitive Predictors of Response to Treatment for Depression in Multiple Sclerosis

Supportive Group Therapy for Parents who Chronically Neglect Their Children

The purpose of this study was to provide a qualitative analysis of neglecting mothers’ responses to participation in an evidence-based model of supportive group therapy. Six mothers with a history of neglecting their children were invited to participate. Two social workers applied a previously evaluated model of group psychotherapy for severe personality disorder. The analysis of transcribed therapy sessions yielded salient themes as to participants’ involvement in group process. Post intervention follow-up interviews provided participants’ subjective reflections on positive changes in interpersonal encounters with their children, partners, and the child welfare system. Although providing this intensive group program is costly, follow-up interviews showed that the chronically neglecting mothers viewed their participation in the group as having been helpful.

EMDR integrative group treatment protocol: A postdisaster trauma intervention for children and adults.

Eye movement desensitization and reprocessing (EMDR) is recognized as an effective and efficient treatment for trauma-related issues. This article describes an integrated EMDR and group treatment for children and adults traumatized by natural disasters in several Latin American countries. This protocol combines the eight standard EMDR treatment phases with a group therapy model. The hypothesis is that the resulting hybrid offers more extensive reach than did the original EMDR model, which was intended for use with individuals, and takes treatment efficacy and efficiency well beyond that expected from traditional group process. To illustrate the application of the model, one formally measured field study and nine pilot projects are described. The promising results of this intervention suggest that EMDR is an effective means of providing treatment to large groups of people impacted by large-scale traumatic events (e.g., natural disasters). Controlled research is needed to clarify this issue.

Changes in eating behaviour following group therapy for women who binge eat: a pilot study

Survey research is demonstrating that binge eating and compulsive eating may be a significant problem in the obese population. There is higher incidence of binge eating among women, associated with subjective distress and poor prognosis for weight control. Despite attendant health risks, researched clinical responses have not been developed. A before and after uncontrolled pilot study aimed to evaluate the effectiveness of group therapy for women who binge eat and compulsively eat. Participants attended a weekly integrative therapy group for 6 months. Measurements before and after the group intervention were taken using the Binge Eating Scale and Clinical Outcomes in Routine Evaluation inventories. Before and after interviews were thematically analysed for changes in eating behaviour. Following the group intervention, all participants demonstrated changes in eating behaviour measured by the Binge Eating Scale, the overall effect from baseline to 1 year demonstrates statistical significance. Qualitative data revealed four categories that underpinned reduction in binge eating: changes in dichotomous thinking, awareness of eating behaviour, detachment from food and dietary changes. An integrative model of group therapy warrants further research and refinement for this population, a group protocol for nurses working in the field of obesity and eating disorders could be developed.

Using a model of group psychotherapy to support social research on sensitive topics

This article describes the exploratory use of professional therapeutic support by social researchers working on a sensitive topic. Talking to recently bereaved parents about the financial implications of their child’s death was expected to be demanding work, and the research design included access to an independent psychotherapeutic service. Using this kind of professional support is rare within the general social research community, and it is useful to reflect on the process. There are likely to be implications for collection and interpretation of data, research output and the role and experience of the therapist. Here, the primary focus is the potential impact on researcher well‐being.

Group therapy with international LGBTQ+ clients at the intersection of multiple minority status

Members of sexual/gender minority groups, who are also immigrants and refugees face multiple problems in adapting to their new cultures. Often their sexual interests or gender expression was stigmatised, pathologised, criminalised and persecuted in their home cultures/countries. In this article, we discuss the special problems with acculturation to their new cultures faced by such individuals in a North American milieu. They are at the intersection of multiple minority identities (i.e. ethnic, racial, religious, immigrant, refugee). We provide a model of group therapy for international LGBTQ+ clients who have been persecuted for their sexual/gender minority expressions. Clinical, professional and ethical considerations are explored for dealing with international sexual/gender minority clients in therapy. The conclusion includes recommendations for professional development and for broadening the sphere of knowledge and training in the field.

“I’m Not the Only One!” Group Therapy with Older Children and Adolescents Who Have Learning Disabilities

Children and adolescents with learning disabilities (LD) are vulnerable to psychosocial difficulties. Both the detrimental impact of LD on social adjustment and the significance of peer relations for developmental needs make group therapy a natural intervention. Despite modifications that are required due to their cognitive deficits, many students with LD fit the criteria and can benefit from group psychotherapy. In this paper, a model of group therapy for older children and adolescents with LD is presented. The approach is informed by a combination of self psychology, mutual aid, and interpersonal group therapy. The leaders use special techniques to accommodate the LD and to foster the group process. Examples are presented to illustrate the approach.

Group Psychotherapy with Obese Disordered-Eating Adults with Body-Image Disturbances: An Integrated Model

Body-image disturbances and body-image misperceptions are common phenomena in the adult obese or disordered eating population, but they have received scant notice in group psychotherapy literature. This paper integrates an important missing conceptual link of body-image development and offers a group psychotherapy treatment model. This paper does not address the eating disorders, i.e., bulimia and anorexia nervosa. The integrated concept described here will show how a group psychotherapy model can effectively treat body image disturbances which often stem from developmental deficits. It also addresses problems with those patients, who, after weight loss, continue to have misperceptions of their size and shape, and experience shame and self-loathing as a result.

Performance measures for outpatient substance abuse services: Group versus individual counseling

Most substance abuse treatment programs employ various models of group therapy. Empirical evidence, however, of the benefits of group vs. individual treatment is scarce. This study examined the impact of type of treatment, defined as individual or group counseling, on treatment performance, as measured by treatment completion and goal achievement. Data on clients treated in publicly funded substance abuse outpatient treatment programs were drawn from the Massachusetts Substance Abuse Information System. A larger proportion of group to individual therapy was strongly and positively associated with increased likelihood for improved measures of treatment performance. State data systems can provide useful insights into the development and application of performance measurement.

Strivings and Expectations: An Examination of Process in Groups for Persons with Chronic Mental Illness

A model of group psychotherapy for persons with chronic mental illness is organized to provide members with some autonomy regarding treatment dosage and to address, within the group, problematic social relationships. Within this system, the therapist's application of self-psychological theory attends to members' efforts to change and grow (forward strivings) rather than to their repetition of prior traumatic relationships (expectations). Examples from established groups illustrate the therapist's attending to patients' strivings and “testing” to see if patients' cautious efforts to try new experiences are acknowledged and appreciated and, if so, whether there also is evidence of forward movement.

Recovery from Sexual Assault: An Innovative Two-Stage Group Therapy Model

This article describes an innovative two-stage model of sexual assault therapy groups for women in a university setting. This model is recommended for use in various settings and includes a supportive therapy group and two specialized therapy groups, one for childhood sexual abuse survivors and the other for sexual assault (acquaintance rape and stranger rape) survivors. Theoretical underpinnings of the model are discussed in addition to practical aspects of group development such as elements of an effective group, screening of potential members, and marketing and recruitment techniques.

Grace Therapy: Meeting the Challenge of Group Therapy for Male Batterers

Grace Therapy is a relatively new model for male batterers' group therapy, based on the 12-Step program. Grace Therapy attempts to address the marked suspicion of and resistance to treatment that most male batterers display, while offering several principles that work together to enhance the men's affiliation with the group—modularity, immediacy, group and therapist availability, accessibility, acceptance, and mutual help. Grace Therapy considers battering to be a three-leveled phenomenon: physical/behavioral, mental and spiritual. The respective treatment goals range from abstinence from any manifestation of violence, leading up to a self-transformation at the spiritual level that replaces self-centeredness with “God-centeredness,” in which the man becomes non-violent. During the change process, the men learn how to adhere to a letting go Win-Win principle of partnership, based on unconditional giving. A range of case studies and the first-hand testimony of the second author, a recovering male batterer, support the description.

Self-Disclosure With All-Male Groups

Given the relational deficits men bring to a group, therapist self-disclosure is particularly pertinent with all-male groups. The use of this intervention reflects the author’s long experience with such groups. The author writes from an interpersonal, collaborative model of group therapy, and discusses types of self-disclosure and the guiding principles in their use. Drawing primarily from his own practice, the author presents and discusses clinical vignettes that illustrate both helpful and nonhelpful uses of self-disclosure.

Primary Process and Peer Consultation: An Experiential Model to Work Through Countertransference

Various models exist for peer supervision and consultation of group therapy. This article documents the authors’ experience using an experiential group consultation of group therapy model that relies on primary process to overcome countertransference dilemmas. A review of group therapy supervision and consultation models is followed by vignettes from the authors’ experience. Discussion of the vignettes highlight critical issues in group consultation and expound upon the strengths and challenges of using an experiential model.

Multiple Family Group Therapy: An Interpersonal/Postmodern Approach

Multiple Family Group Therapy has been identified as a viable treatment model for a variety of client populations. A combination of family systems theories and therapeutic group factors provide the opportunity to explore multiple levels of intrapersonal and interpersonal relationships between families. All group members are afforded the opportunity of both giving and receiving feedback about strengthening their own family ties. This article depicts a Multiple Family Group Therapy model based on interpersonal and postmodern theories of therapy. A theoretical base is provided in conjunction with descriptions of weekly activities.

Group Therapy: Essential Component for Success with Sexually Acting Out Problems among Men

Sexual acting out behavior has become a major issue in the United States, with more mental health care professionals seeking assistance in providing effective treatment for this complex and interesting population. Reviews of the literature support the fact that specialized treatments often can be effective (Schwartz, 1995); however, without targeted interventions, recidivistic behaviors can be very high. Innovative approaches are all too uncommon. Many suggest group therapy is an essential, as well as cost-effective, component of a comprehensive treatment program (Schwartz, 1995; Freeman-Longo & Blanchard, 1998). In this article, a model for group therapy for men with a range of sexually acting out problems is presented. This semi-structured group therapy model combines psychodynamic cognitive-behavioral theoretical perspectives in a 16-week module in which structured exercises and group process-oriented interventions are employed. In this article we discuss group format, content, and process in an effort to elucidate the specific challenges and common issues of this population.

Integrative Time-Limited Group Therapy for Bulimia Nervosa

This article presents an integrative group therapy model for the treatment of bulimia nervosa (BN) and describes the 12-session format, incorporating components of cognitive-behavioral therapy (CBT), psychoeducation, interpersonal therapy (IPT), and relational therapy (RT), in detail. Previous reports have found CBT, IPT, and RT to be effective approaches for BN when used separately. The integrative approach may have the advantage of achieving symptom reduction by two different mediating mechanisms, those that directly affect eating behaviors and those that address the interpersonal and relational context in which the disordered eating has developed. The group approach makes use of the peer group in providing new opportunities for self-exploration and self-correction. One advantage of an integrative model is patients’ exposure to several different treatment modalities from which they can identify specific approaches that are most helpful to their recovery. This identification is valuable in directing future treatment, if needed. Pilot data for this approach are presented.