Time-limited Psychotherapy Groups Research Articles

A conversation analysis of communicative changes in a time-limited psychotherapy group for mothers with post-natal depression

ABSTRACT Objective: To examine qualitatively changes occurring in discussions within a time-limited psychotherapy group for mothers with post-natal depression. Method: Discussions occurring in a group that comprised five mothers and a therapist were recorded over the course of six one-hour therapeutic sessions. Participants had been referred or had self-referred to the group on the basis of having post-natal depression. The recorded discussions were transcribed and then analysed in accordance with principles of conversation analysis. Results: Analysis of early and later group discussions showed changes in group members’ alignment with the topics that were introduced, in turn-allocation and turn-taking, and in the co-construction of accounts of experience. In contrast to early discussions, in later discussions participants aligned with topics relating to personal emotions, self-selected as next speakers in the discussions, and collaboratively worked up accounts that made sense of their experiences of childbirth and of being diagnosed as having post-natal depression. Conclusions: Interactional changes over the duration of the group point to the benefits for mothers with post-natal depression of participating in a time-limited psychotherapy group. Fine-grained analysis of group discussions potentially offers a way of examining changes over time in psychotherapeutic groups more generally.

Receiving slaps, receiving words. The violence of separation in a public service time limited psychotherapy group for adolescents

The authors propose a reflection on a time-limited psychoanalytic group for children, adolescents and families, run in a public service. Some patients in the group give accounts of violent relationships and traumatic experiences. The accounts of violent, interpersonal and intrapsychic relationships influence the group’s capacity of thinking, which leads to difficulties in the processing of symbolic aspects. The fundamental question is that of whether it is possible to work in a time-limited, institutional, psychoanalytical framework, in which psychotherapists have to attempt to give meaning to experiences which take place in a repetitive present, in a space/time in which the prospect of a conclusion appears to be inconceivable. By means of a clinical example, and with particular emphasis on the first sessions and the dream brought up by a patient who has been a victim of domestic violence, the authors discuss the possibility of modifying, chiefly from within, the feeling of the immutability of early psychic material, which is itself intrinsically violent.

Variazioni del setting in una psicoterapia di gruppo a tempo limitato: un'insolita e significativa esperienza

This work deals with the experience of a time-limited psychotherapy group in a Mental Health Department. The group is conducted following the S.H. Foulkes’ approach and to the clinical didactic team methodology of Fabrizio Napolitani. The setting, in the first year, involves ninety minute weekly sessions with two observers, and in the second, recorded sessions held in the group members’ houses, in rotation. The facilitator listens to the cassette and gives suggestions and clarification by telephone. Quarterly, he meets the group for a checkup. During the third year, the patients continue to hold weekly meetings, completely autonomously. .

‘Coming out’ with Alzheimer's disease: Changes in awareness during a psychotherapy group for people with dementia

This paper forms part of the second phase of a project looking at those changes that occurred for participants during a series of time-limited psychotherapy groups for people with dementia. Using the Assimilation of Problematic Experiences Scale (APES), the accounts of one participant (Robert) are analyzed across the course of the group. Robert moves from a position in which he wards off awareness that he has dementia of the Alzheimer's type, to being able to joke about having brain changes that are symptomatic of the illness. This change in his discourse about Alzheimer's disease was accompanied by an increase in Robert's levels of affect. However, reflecting on the changes that had occurred for him, Robert commented that before he came to the group he had been frightened, thinking that ‘I’m going crazy … what am I going to be like in another five years?’. For Robert, coming to the group had meant that this fear had been replaced by the knowledge that he was not alone. In the light of the move towards early diagnosis, the importance of this model of change in awareness as a means of increasing understanding of the process of emotional development is discussed. ‘… but I think that a lot of people who I have met who have come out about Alzheimer's were quite shocked because I said that. It did help, it may not have helped others, but I suppose that it helps overcome a feeling of being different.’ Janet, session six.

Group Psychotherapy for Adolescent Survivors of Homicide Victims: A Pilot Study

To conduct an exploratory study designed to evaluate the effectiveness of a time-limited psychotherapy group model to decrease traumatic symptoms among adolescent survivors of homicide victims. Forty-five inner-city adolescents between the ages of 11 and 19 years participated in community-based, time-limited therapy groups that were specifically designed for youths who had a loved one die because of violence. The therapy groups were based on a 10-week treatment model for adolescent survivors of homicide victims with the goals of providing grief education, facilitating thoughts and feelings about grief, and reducing traumatic symptoms. On completion of group therapy, the adolescent participants reported an overall significant decrease in traumatic symptoms on an index of posttraumatic stress, especially in the areas of reexperiencing and avoidance symptoms. The mean difference between pre- and posttest was a 10.03 decrease in the sum of the Child PTSD Reaction Index scores (sig = .001). The results of this pilot study indicate that group therapy may be helpful in reducing PTSD symptoms among inner-city, African-American adolescent survivors of homicide victims. Although validity is limited by the lack of a comparison group, the authors suggest that such a brief trauma/grief psychotherapy group may be applicable for suburban and rural adolescent survivors of homicide victims as well. .

The Effects of Pretraining on Group Psychotherapy For Incest-Related Issues

ABSTRACTThe effects of written, cognitive pretraining on self-reported self-disclosure and cohesion in group psychotherapy were studied. Subjects were members of time-limited psychotherapy groups that focused on incest-related issues. The experimental groups were given written cognitive pretraining designed to increase self-reported self-disclosure and cohesion. The control groups received general group information. Subjects in the pretrained groups reported higher levels of self-perceived self-disclosure than the control groups after sessions 4 (p = .003) and 8 (p = .003). Self-reported self-disclosure did not increase over time for pretrained or nonpretrained subjects. Cohesion did not differ across groups, but increased over time for experimental subjects (p = .008), and not for control subjects.

Time-limited group psychotherapy.

The presence of a time limit shapes the entire therapeutic process and culminates in the management of termination. This paper outlines a protocol for dealing with termination in time-limited psychotherapy groups: (1) Select suitable members with similar capacity to use a time-limited format; (2) use a closed group format; (3) clarify the time boundaries at the beginning; (4) reinforce the time frame during the last half of the group; (5) provide focused interventions; (6) forestall premature termination; (7) reinforce termination themes of deprivation, resentment and anger, rejection, grief and loss, responsibility for self; (8) structure the final session; and (9) plan a 4-month follow-up visit to encourage ongoing application. These guidelines provide the therapist with a general structure to ensure that major termination themes are systematically addressed. They deal with powerful concepts of maturation and self-responsibility and incorporate the principal strategies that distinguish time-limited from time-unlimited group psychotherapy.

A planning checklist for establishing time-limited psychotherapy groups.

A planning checklist for establishing time-limited psychotherapy groups.

Cohesion, Alliance and Outcome in Group Psychotherapy

Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.

Speech behavior measures of group psychotherapy process

Two behavioral measures are presented which can be used in the analysis of phase and leadership emergence during group development. They are length of statement and the use of the pronoun “we” in reference to the group itself. These measures are applied to the typed transcripts of group therapy sessions. The paper focuses on phases two and three as these are described in Beck's theory of group development. Results of the analysis on three time-limited psychotherapy groups are presented with special emphasis on the Scapegoat Leader's role. A description of the highlights of both phases and some clinical implications of the results are included.