Group Therapy Model Research Articles

Treatment of Non-incarcerated Sexually Compulsive/Addictive Offenders in an Integrated, Multimodal, and Psychodynamic Group Therapy Model

Group therapy is a widely accepted model of care for sex offenders. However, most group therapy takes place in prison utilizing a cognitive-behavioral, psychoeducational model of care. Given that over 250,000 sex offenders are in ambulatory treatment, newer models of care may need to be employed to address their specific needs. I present a naturalistic outpatient study involving my private practice of 109 consecutive sex offenders treated over a 10-year period. A multimodal model of care informed by psychodynamic theory is presented with detailed case material from one group session. Preliminary results of recidivism are presented.

Group and family cognitive behavior therapy for adolescent depression and substance abuse: A case study

Cognitive behavior therapy (CBT) has been demonstrated to be an effective acute intervention for adolescent depression. However, studies to date of CBT with depressed adolescents have excluded those with comorbid substance abuse. Treatment of comorbid substance abuse requires that the targets of CBT be expanded to include social cognitive and family factors associated with the substance use disorder. We developed an integrated group and family therapy model of intervention for adolescents with both depression and substance abuse. The case of R.P. illustrates the application of this treatment model. Treatment includes skills training in the context of a closed, mixed-gender, twice-weekly adolescent group and weekly family therapy sessions to apply new skills in the family context. Central clinical issues and core cognitive and behavioral correlates of R.P.'s depression and substance abuse are delineated as they occurred during the course of treatment. Treatment was associated with improvements in mood and reductions in substance use.

The group-as-a-whole-object relations model of group psychotherapy.

The authors review the theoretical basis of group psychotherapy performed at The Menninger Clinic and demonstrate how the theory has been put into practice on two different types of inpatient units. The fundamental elements of the theory and practice used can be traced to object relations theory as originally proposed by Melanie Klein. Her work with individuals was directly applied to working with groups by Ezriel and Bion, who focused on interpreting group tension. More modern approaches have reintegrated working with individual concerns while also attending to the group-as-a-whole. Historically, these principles have been applied to long-term group treatment. The authors apply the concepts from the group-as-a-whole literature to short- and medium-length inpatient groups with open membership. They offer clinical examples of the application of these principles in short-term inpatient settings in groups with open membership.

Psychosis: Psychological Approaches and Their Effectiveness

Back to table of contents Previous article Next article Book Forum: PsychotherapiesFull AccessPsychosis: Psychological Approaches and Their EffectivenessRALPH N. WHARTON, M.D., RALPH N. WHARTONSearch for more papers by this author, M.D., New York, N.Y.Published Online:1 Aug 2001https://doi.org/10.1176/appi.ajp.158.8.1349AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This excellent text has certainly achieved its goal in promoting a better balance between psychological and pharmacological treatments for the well-being of those individuals suffering from severe psychoses throughout the world. I heartily endorse this fruitful and thoughtful approach for students, researchers, and clinicians who are treating the acutely and chronically ill.In his foreword, John Cox of the Royal College of Psychiatrists challenges those with parochial views of neuroscience, genetics, or environmentalism to educate themselves broadly. His clarion call for psychotherapists who have cognitive, dynamic, humanistic, interpersonal, and family orientations should be heard.The book is structured in sections on 1) cognitive approaches, 2) family, group, and psychosocial approaches, 3) individual psychoanalytic psychotherapy, 4) early interventions using need-adapted psychological treatment models, and 5) an Australian overview. These sections vary from single chapters of 10–30 pages each to three chapters per topic.After a fine introduction in which there is clear redefinition of the reductionistic view of radical psychopharmacologists and overview of the book, Philippa Garety of King’s College and her colleagues review the current cognitive behavior therapy endeavors in three U.K. groups. They focus on current theory, therapy, and outcome research and also address acute treatment techniques.Chapter 3, by Peter Hayward of the Institute of Psychiatry, London, reviews barriers to compliance with pharmacotherapy and therapeutic principles to improve compliance. Chapters 4–8 cover multifamily groups, psychosocial family interventions, and group therapy models of treatment. The designs of programs to prevent relapse and crisis residential treatments are perhaps the best in the volume. McFarlane’s studies on the U.S. East Coast clearly define benefits and limitations of psychoeducational models. Baguley’s efforts with community psychiatric nursing approaches in Manchester, U.K., define the limitations of these approaches. Kanas of the University of California, San Francisco, briefly reviews 30 years of the literature and the limits of group therapies from around the world. Problems remain in the selection of patients for long-term versus short-term groups. Davidson’s focus on the themes of social isolation, demoralization, and disconnection in a pilot study of a novel intervention is intriguing. Fenton and Mosher’s study of residential care is certainly innovative as well and is cost-conscious enough to please every health maintenance organization. What it and these other models will do in the long run to solve the enigma of schizophrenia remains to be seen. The brilliant laboratory models of the wiring of the nervous system in mouse gene knockout models are a long way from these clinical realities.Chapter 9, by Siani and Siciliana, takes us from Verona, Italy, to Scandinavia, and then to the United States in efforts to use in-depth psychoanalytic principles to show improvement in interpersonal relationships in psychotic patients. Chapters 10–12 enrich the perspective by adding studies from Sweden, Norway, and Finland; these chapters add thoughtful new dimensions. There is the creative multicenter Parachute Project in Sweden as well as another multicenter project whose aim is to reduce the duration of untreated psychosis in an early treatment and identification public health program. The schizophrenia project in Turku, Finland (which started 30 years ago), in which pharmacotherapy is considered an adjunct support to a basic psychotherapeutic model, provides worthwhile new data. The chapter authors find that the use of neuroleptic medication is not as mandatory as has been suggested and that there are cases, interestingly, where neuroleptics should be avoided.Lastly, McGorry’s Australian overview is indeed that, even if it comes from “downunder.” He blends the rich tributaries of psychoanalysis and behaviorism. From the Andreasen scale to Fromm-Reichmann to Sullivan to Tienari and Wynn, chapter 13 provides a wonderful coda to the mysteries of schizophrenic psychoses at the start of the 21st century.Edited by Brian Martindale, Anthony Bateman, Michael Crowe, and Frank Margison. London, Gaskell (Washington, D.C., American Psychiatric Press, distributor), 2000, 306 pp., $35.00 (paper). FiguresReferencesCited byDetailsCited ByNone Volume 158Issue 8 August 2001Pages 1349-1349 Metrics History Published online 1 August 2001 Published in print 1 August 2001

An integrated model for adolescent inpatient group therapy.

This paper proposes an integrated group therapy model to be utilized by psychiatric and mental health nurses; one innovatively designed to meet the therapeutic needs of adolescents admitted to inpatient psychiatric programs. The writers suggest a model of group therapy primarily comprised of interpersonal approaches within a feminist perspective. The proposed group focus is on active therapeutic engagement with adolescents to further interpersonal learning and to critically examine their contextualized lived experiences. Specific client and setting factors relevant to the selection of therapeutic techniques are reviewed. Selected theoretical models of group therapy are critiqued in relation to group therapy with adolescents. This integrated model of group therapy provides a safe and therapeutic forum that enriches clients' personal and interpersonal experiences as well as promotes healthy exploration, change, and empowerment.

Walking in the shadow: examining a model for group psychotherapy with patients facing advanced cancer

Walking in the shadow: examining a model for group psychotherapy with patients facing advanced cancer

Solution-Focused Group Psychotherapy for Incarcerated Fathers

This article describes the rationale for the development of solution-focused psychotherapy groups for incarcerated parents, and the planning and implementation of a parenting group at a state medium security correctional facility for men. The development of the group encompassed a needs assessment, selection of an appropriate model of group psychotherapy, screening of group members, implementation of the group across 12 weekly sessions, and an assessment of outcomes. The appropriateness of solution-focused approaches with incarcerated clients is emphasized, and recommendations for further practice and research are discussed.

The place of group psychotherapy in the treatment of personality disorders

Empirical research to assist health professionals in the development of group therapy models, to guide treatment differentiation, and to enhance the understanding of group processes for patients with personality disorders is advancing slowly. Recent efforts to investigate the relationship between group process variables and outcomes are therefore valuable contributions. Important studies have been published on comprehensive treatment programmes, relying heavily on group therapies, for the more severely disturbed patients.

Reflections on Group Treatments as Corrective Experiences for Addictive Vulnerability

This article addresses how and why groups help people with addictive disorders feel better and change. It advances the position that problems in self-regulation and the psychological suffering that ensues are at the root of addictive disorders. Group work is especially effective in addressing these problems, providing a means of relief, and examining co-occurring characterological problems. The evolution of these ideas and the generation of a model for group therapy for substance abusers are traced over a 30-year period, and a list of principles about how and why group treatments work is presented. In addition, a number of advantages that group psychotherapy has over 12-step programs for some patients are provided. Group psychotherapy is presented as a unique corrective emotional experience.

Adapting the Pynoos School Based Group Therapy Model for Use with Foster Children: Theoretical and Process Considerations

Children who enter foster care are removed from their homes, their families, and everything else that is familiar. They are then placed with strangers. Once protective services are initiated, separation from biological parents is likely to further traumatize these children, even if they had previously been neglected and/or abused. As a result, foster children experience trauma on multiple levels. Trauma experiences are often enacted behaviorally in ways that disrupt the children's capacity to learn as well as their peer relationships at school. Accordingly, it seems logical to provide school based services that address specific manifestations of trauma related behavior. Robert Pynoos has developed a model for work with children who have experienced trauma. The model includes individual and group counseling, a mentor for the children and group counseling for the parents. This paper discusses an adaptation of the model's school based group component, specifically designed to address the emotional, social and by implication, the educational needs of children who were currently, or had recently lived in out-of-home foster placements. The group was conducted in an inner city elementary school with a large enrollment of at-risk children.

Adolescent Development and a Model of Group Psychotherapy: Effective Leadership in the New Millennium

Adolescent Development and a Model of Group Psychotherapy: Effective Leadership in the New Millennium

Peer rejection and neglect of latency-age children: pathways and a group psychotherapy model.

Children's peer relations are one of the most powerful predictors of mental health Peer rejection and neglect are associated with depression, academic problems, school withdrawal, and delinquency. To provide brief introductions to models of social development and peer rejection, and to introduce a developmental-group psychotherapy model for children experiencing peer neglect or rejection. Theoretical and empirical literature, as well as clinical experience. Early identification and intervention with children vulnerable to peer rejection are essential. Research addressing affective experiences of peer-rejected children and the relationships between self-perception and treatment outcomes is needed.

Patient satisfaction with two models of group therapy for people hospitalized with bipolar disorder

The purpose of this study was to (a) compare participants' evaluations of two models of inpatient group therapy for people with bipolar disorder and (b) develop a taxonomy of patient satisfaction with such groups. The sample of 110 people included 59 participants in the self-management groups and 51 participants in the interactional groups. Results indicated that although neither of the models was clearly preferred by participants, the responses were useful in identifying needed changes, and the benefits of providing inpatient diagnostically homogeneous groups for this population were evident. A refined self-management model that incorporates agenda setting in the format, and a taxonomy for use in future research, are presented.

A sequenced group psychotherapy model for bulimia nervosa patients: a pilot study

A sequenced group psychotherapy model for bulimia nervosa patients: a pilot study

A sequenced group psychotherapy model for bulimia nervosa patients: a pilot study

A sequenced group psychotherapy model for bulimia nervosa patients: a pilot study

Enhancing the Self-Esteem and Social Competence of Hyperactive Children: A Semi-Structured Activity Group Therapy Model

This article proposes a semi-structured activities group model for addressing the fragile self-esteem and social discord often shown by hyperactive children. Included is a discussion of the amount of structure and types of activities necessary to foster effective group work with this client population. The author asserts that hyperactivity oftentimes is better conceptualized in terms of unmet exhibitionistic needs, the sensitive handling of which can impact the acquisition of healthy self-esteem. Another key focus is the role of shame in manifestations of aggression and externalization of blame that diminish the social competence of hyperactive children. Clinical vignettes are used to illustrate key points.

Evolution of a Group Therapy Model for Adolescent Residential Treatment

This paper discusses the development of a group psychotherapy process for adolescents on a residential treatment unit. We found that consideration of four factors were important in the creation of a productive group. (1) Group therapy should be tailored to the developmental level and needs of this age group. (2) Group leaders need to remain aware of staff and patient dynamics outside of group. (3) Group psychotherapy should be clearly defined as different than other groups within the structure of the unit. (4) Co-leaders should be knowledgeable about the basic group dynamics. Vignettes are provided to illustrate how an effective group psychotherapy was established in the context of an adolescent residential unit. The use of a nonparticipant-observer is discussed.

Psychodynamic-Supportive Group Therapy Model for Elderly Holocaust Survivors

ABSTRACTThe physical and mental consequences of the Holocaust combined with difficult present events and the problems of old age can have devastating effects on survivors. Our clinic has recently introduced a psychodynamic-supportive group therapy model for elderly Holocaust, survivors. The model includes specific integrative interventions, which are based on Horowitz's model, of mourning and coping with stress and the leaders' clinical experience. The aim of the group is to improve the patients' homeostasis and enhance their ego functions and adaptation to inner and outer worlds. The theory and working model, are described.

Time-Managed Group Psychotherapy: Effective Clinical Applications

Back to table of contents Previous article Next article Book ReviewFull AccessTime-Managed Group Psychotherapy: Effective Clinical ApplicationsAlbert J. Villapiano, , Ed.D., C.G.P.Albert J. VillapianoSearch for more papers by this author, , Ed.D., C.G.P.Published Online:1 Jun 1998https://doi.org/10.1176/ps.49.6.838AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Roy MacKenzie has made another important contribution to the group treatment literature in support of time-effective and diagnosis-related group treatment models. His previous books entitled Introduction to Time-Limited Group Psychotherapy and Effective Use of Group Therapy in Managed Care helped those of us working in and consulting to diverse clinical settings rethink the way we provided our services.These earlier works gave us some direction on how the health care landscape was changing in regard to managed care, and they summarized the rationale and clinical justification for time-limited and diagnosis-related groups in a variety of settings. Now that a solid research base supports the efficacy of group treatment, including time-limited models, MacKenzie's current book builds nicely on his previous writings, addressing theory, clinical applications, and program development issues.MacKenzie thoughtfully describes a generic model of psychotherapy applicable to group treatment that transcends any one theoretical focus and that recognizes the therapeutic forces at work in group treatment. It draws from interpersonal, dynamic, cognitive, and behavioral schools of thought. Most clinicians who have led groups in a variety of settings will quickly relate to the importance of this integrative approach in meeting the needs of diverse populations and clinical presentations.Much of the book is devoted to a review of the theory and practice of time-managed group psychotherapy. Both experienced and novice group clinicians will appreciate the attention to detail and the specific suggestions about tailoring style and technique to the different stages of a group's life and members' behavior. It is refreshing to read about the importance of a continuum of leadership activity and the emphasis on the value of support and education. MacKenzie asserts that structure and a relatively higher level of leader activity can lessen group members' anxiety, make self-disclosure easier, and accelerate members' involvement. These are all critical issues in time-limited group experiences, where the opportunity for the gradual development of group process does not always exist.The author supports massaging the interactional process and holding session debriefings to increase the likelihood of personal understanding and cognitive integration of the group experience. He encourages the use of homework, such as journal writing, to take learning outside the session. Depending on the group focus, a variety of cognitive-behavioral interventions are employed, such as training to challenge negative thinking patterns.The final third of the book addresses systems issues in developing group programs. Included are a helpful readiness checklist, a review of several models of group therapy, and an appendix with useful forms, scales, and information sheets. The group therapy models apply the principles of the generic model to a range of purposes or topics, such as crisis intervention, eating disorders, and substance abuse. These sections are not how-to manuals, but rather helpful guidelines for experienced clinicians or novice clinicians receiving supervision.Time-Managed Group Psychotherapy: Effective Clinical Applications is a valuable text for group clinicians and for those wishing to develop their group leadership skills. It presents an integrative model of thinking about groups and embraces the importance of diverse and flexible applications of group leadership skills. I also appreciate MacKenzie's acknowledgment of the importance of skill development, support, and outside-of-therapy activity, such as homework, to improve patient-client outcomes—issues all too often neglected in more traditional behavioral health care practice.Dr. Villapiano is director of training and consultation for Innovative Training Systems in Newton, Massachusetts, and is in private practice in Newton.by K. Roy MacKenzie; Washington, D.C., American Psychiatric Press, 1997, 453 pages, $67.50

Group Therapy for Boys with Features of Asperger Syndrome and Concurrent Learning Disabilities: Finding a Peer Group

In this paper, we present a pilot group therapy model with modifications, for boys who meet the criteria of Asperger Syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994), and who have concurrent learning disabilities. It is recognized that learning disabilities are often a feature of Asperger Syndrome. Children and adolescents with learning disabilities are vulnerable to experiencing social and emotional problems, in particular difficulties with peers. The social functioning of children and adolescents who have Asperger Syndrome is greatly impeded, although they are motivated to have social contact and to make friends. This paper describes how elements of interpersonal group therapy were combined with modifications, which address the unique social and cognitive profiles of the boys in this group. Case examples are provided to illustrate the group model. The group members and their parents were interviewed after the group and two years later, to obtain their views of the group. Their responses are presented.