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109 Cards in this Set
- Front
- Back
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Psychodynamic and
Interpersonal Groups --Assumptions-- |
• Change occurs in the “Here-&-Now”
• Interpersonal Learning occurs at several levels • Corrective emotional experience more important than insight |
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Psychodynamic and
Interpersonal Groups --Intervention Strategies-- |
• create appropriate group culture allowing study of interpersonal Bx
• Feedback given with immediacy, focus on sender message, affective language |
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Self-Help Groups
--Assumptions-- |
• Voluntary collection of ppl gathering to share concerns, support/cope
• Generally w/o formal leadership • Equality among peers • Self-disclosure & listening elicit peer support and reduce social isolation • ex., Alcoholics Anonymous |
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Self-Help Groups
--Intervention Strategies-- |
Facilitate cognitive restructuring by encouraging self-disclosure and peer support
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Type of Group Emphasizing
• Relatively brief time-frame • Focused on specific population/goals • Imparting information • High structure |
Psychoeducational Groups
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Psychoeducational Groups
--Intervention Strategies-- |
• sharing information
• low to moderate levels of process • some emotional content |
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Brief Groups
--Assumptions-- |
• More structured
• More active leadership • Often focused on specif. pop. or theme • Settings include: Outpatient/Inpatient, Partial Hospitalization, Managed Care |
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Brief Groups
--Intervention Strategies-- |
• Maintain clear/specific focus
• High level of therapist activity • Awareness of sessions remaining • Encourage clients' work outside of therapy through "homework" |
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Support Groups
--Assumptions-- |
• Emphasis on conscious material
• Support of existing healthy defenses • Identifies available int/ext resources • Facilitate ego functioning, capacity for growth, coping, mastery |
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Support Groups
--Intervention Strategies-- |
• Cognitive & Didactic elements
• Modeling • Advice Giving • Suggestions • Bx Prescriptions • Teaching • Homework Assignments |
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Group as a Whole
(Bion, Foulkes, Lewin) |
TENSIONS BETWEEN
• Individual vs. Collective needs • Authoritarian vs. Democratic patterns |
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Functions of a Focus on
the "Here & Now" |
• Experiential: allowing "in vivo"
affective involvement • Illumination: forming new cognitive framework of present experiences |
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focus on "process" or feelings about disclosure
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Horizontal Disclosure
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disclosures focused on content
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Vertical Disclosure
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The unstructured flow of affect, behaviors, and cognitions that are manifested both verbally and nonverbally.
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Process
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Bridging (Ormont)
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Interventions aimed at strengthening emotional bonds and generative communication between group members
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Types of Bridging
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• Simple Similarity Bridge
• Consulting Bridge • Reactive Bridge |
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Contracting (Ormont)
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• Setting ground-rules for group
• "Groupalogue" vs. mono/dialogue • Managing Aggression • Communication of Emotions |
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Immediacy (Ormont)
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Group as "treatment of immediate experience" (i.e., Here & Now)
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Induction of Group Resistance
(Ormont) |
utilizing countertransference to shed light on group processes
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Interventions for
Resistances to Intimacy (Ormont) |
• Identify Defenses
• Dispel Irrational Fears • Develop Mature Intimacy Patterns |
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collection of two or more individuals, meeting in face-to-face interactions interdependently, with an awareness that each belongs to the collective, and for the purpose of achieving mutually agreed upon goals
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GROUP
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Characteristics of a Group
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• Comprised of parts
• Relationship between parts • An organizing principle |
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Optimal Size: Psychodynamic or Interpersonal Groups
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6-8 members
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Optimal Size: Psychoeducational Groups
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10-30 members
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Optimal Size: Support Groups
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8-12 members
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Term describing the blend of client characteristics most conducive to the creation of an effective therapy group
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Composition
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TRUE or FALSE
A generally homogenous level of ego functioning or development will be most conducive to an effective therapy group |
TRUE
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TRUE or FALSE
Heterogeneity on the hostile/affiliative spectrum in terms of group members' interpersonal difficulties and/or character styles will be most conducive to an effective therapy group |
TRUE
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The idea that in a group should have someone they identify with on some conscious aspect of their own self-concept on controlling/submissive spectrum
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"Noah's Ark" Principle
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Group Norms
(definition) |
• Explicitly stated descriptions of what actually happens in a given group
OR • Implicit notions of what other members think/feel about group expectations |
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Groups likely do display:
• Increased search for leadership • More subgrouping • Wider gap b/t talkers & quiet ppl |
Groups larger than Optimum Size
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Behavioral patterns resulting from interactions b/t individual group members' personalities and group processes, both within and in the service (or disservice) of the group
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Group Roles
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Basic Tasks of Group Therapist
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• Providing a Group Contract
• Culture Building • Be Unifying Force for Members |
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Components of Culture Building
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• Establish Norms/Values/Goals
• Activate Here & Now • Focus on Process vs. Content • Translate complaints into Sx • Educate/Coach/Model • Tend to Process via Commentary |
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Three Levels of Process Commentary
in Group Culture Building |
• Individual (Intrapsychic)
• Between Members (Interpersonal) • Group-as-a-Whole (Systemic) |
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Examples of INTRAPSYCHIC Process Manifestations in Group
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• body language
• voice intonations • interaction patterns • common defenses |
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Examples of INTERPERSONAL Process Manifestations in Group
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• patterns of communication
• repetitive areas of conflict • levels of intimacy in interaction |
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Examples of SYSTEMIC
Process Manifestations in Group |
• energy level
• enthusiasm of the group • amount of cohesiveness • avoidance of important group issues |
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Components of Therapist
as Unifying Force for Group Members |
• Caring
• Emotional Stimulation • Meaning-Attribution • Therapist use of Self |
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Meaning-Attribution
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intervention facilitating clients' ability to assign meaning to experiences
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degree to which the group represents a sense of warmth, acceptance, support, and belongingness to members
both for each other individually and for a shared commitment to the group and its primary task |
Cohesion
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often seen as Group Therapy equivalent of the "therapeutic alliance"
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Group Cohesion
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One might describe a group with this characteristic as felling like "a safe harbor"
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Cohesive Group
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Members who fear intimacy often fear this in Group Therapy
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Cohesion
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Types of Group Climate
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• Engagement: positive work atmosphere
• Conflict: tension and anger in group • Avoidance: behavior indicating avoidance of personal responsibility |
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Term used to describe patterns of relationships between and among group participants
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Group Dynamics
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Levels of Group Dynamics
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• Individual (intrapsychic)
• Interpersonal (dyadic) • Sub-group • Group-as-a-Whole • Administrative • Institutional • Socio-cultural • Socio-political |
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Examples of Group
Dynamic Mechanisms |
• Basic Assumption Dynamics (Bion)
• Resistance (Ormont) • Acting Out • Defense Mechanisms • Scapegoating • Transference / Countertransference • Affect Contagion • Role Lock (valence) • Spokespersons • Therapeutic Impasses • Hall of mirrors (mirroring) |
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Clinically effective interventions by therapist or group members involving boundary thresholds
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Boundary Crossing
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Interactions beyond that which is clinically indicated, causing discomfort and/or harm involving boundary thresholds
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Boundary Violation
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Types of Boundaries
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• External Group Boundary
• Leadership Boundary • Therapist Boundary • Personal Boundary of Indiv. Member • Interpersonal Boundary • Internal Boundaries • Subgroup Boundary |
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Boundary Type involving:
recognition of group as unique social system |
External Group Boundary
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Boundary Type that may extend to larger org. or admin. structure
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Leadership Boundary
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Boundary Type involving:
separation between group members/therapist |
Therapist Boundary
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Boundary Type involving:
sense of difference between internal state and how others in group might experience them. Self-disclosures cross this boundary, as does feedback from other members. |
Personal Boundary
of Individual Member |
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Boundaries between group members, (i.e., behavioral norms)
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Interpersonal Boundary
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Boundary type involving:
hypothetical boundaries within the individual (i.e., Johari Window) Known vs. Unknown by Self vs. Other |
Internal Boundaries
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close sense of identification formed between particular group members
can support and/or interfere with group work. Often extends beyond External Group Boundary as well. |
Subgroup Boundary
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Concepts from Systems Theory
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• System
• Boundary • Open Systems • Closed Systems • Permeable/Dynamic Systems • Autonomy • Hierarchy • Isomorphy • Homeostasis • Specialization |
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Components of Bion's
Basic Assumptions Theory |
• Group Operations
• Basic Assumptions |
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2 Levels of Group Operation
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Conscious Level
Unconscious Level |
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Conscious Level
of Group Operation (Bion) |
• a.k.a. "Work Group"
• Bx directed at accomplishing task |
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Unconscious Level
of Group Operation (Bion) |
• a.k.a. "Basic Assumption Group"
• Bx aimed at fulfilling emo. needs, avoiding dreaded relationships in group |
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Define "Basic Assumptions"
(Bion) |
unconscious defensive assumptions re: why group is meeting
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Identify the 3 Basic Assumptions
(Bion) |
• Dependency
• Fight or Flight • Pairing |
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Describe "DEPENDENCY" as it relates
to Bion's Basic Assumptions |
• group members try attaching to leader as omniscient healer figure
• connected w/ unconscious agenda to assuage primitive fears of abandonment, badness, & helplessness |
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Describe "FIGHT or FLIGHT" as it relates
to Bion's Basic Assumptions |
• group meets to fight/flee from enemy
• looks to leader to identify enemy and lead group into battle • group preservation is valued over intellectualism and introspection |
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Describe "PAIRING" as it relates
to Bion's Basic Assumptions |
• group awaits sexual pairing of individual members
• to produce a "messiah" child/idea/creation that will result in ultimate redemption • group may become focused on a "couple" and joke about their sexuality |
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Stages of Group Development
**Tuckman Model** |
• Forming
• Norming • Storming • Performing |
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Stages of Group Development
**Mackenzie Model** |
• Engagement
• Differentiation • Individuation • Intimacy • Mutuality • Termination |
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Phases of Group Development
**Rutan & Stone Model** |
• Formative Phase
• Reactive Phase • Mature Phase • Termination Phase |
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Levels of Group Development
**Rutan & Alonso Model** |
• Oral: trust, greed, safety
• Anal: competitive, paranoid • Oedipal: intimacy, sexuality, jealousy |
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Stages of Group Development
**Common 5 Stage Model** |
• Forming: dependency, anxiety
• Storming: power, conflict • Norming: trust, safety, intimacy • Performing: differentiation • Adjourning: appreciation, loss |
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Stages of Group Development
**Ariadne P. Beck Model** |
• Making a Contract
.....(task leader) • Establishing Group Identity .....(scapegoat leader) • Exploring group identity & direction • Establishing intimacy .....(emotional leader) • Exploring mutuality • Achieving autonomy • Achieving interdependence .....(defiant leader) • Independence • Termination |
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Group Roles
(Ariadne P. Beck) |
• Task Leader
• Emotional Leader • Scapegoat Leader • Defiant Leader |
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Task Leader
(Beck) |
• usually the facilitator
• concerned with understanding & organizing experience of the group • providing focus and clarifying issues .........Emerges in Stage 1 |
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Emotional Leader
(Beck) |
• sociable role
• complements task leader • often well-liked • most change-ready ........Emerges in Stage 4 |
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Scapegoat Leader
(Beck) |
• divergent role
• impulsive • emphasizes differences ........Emerges in Stage 2 |
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Defiant Leader
(Beck) |
• goes up against power of the group
• challenges sense of cohesiveness • feels vulnerable being in group • half in/half out of group ........Emerges in Stage 5 |
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Leader tasks
--PRE-GROUP Phase-- of Group Development |
• assessment of client benefits,
• matching with group • active role • naming anxiety • help members to feel connected • guiding communication |
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Leader tasks
--INITIAL Phase-- of Group Development |
• Orientation, building group culture
• Clarify boundaries • Set clear frame/expectations • Engaging members in dynamics • Sharing/Clarifying Goals |
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Leader tasks
--SURVIVING CONFLICT Phase-- of Group Development |
• Focus on inter-member interactions
• Noting sub-groups • Facilitating negative transferences • Containing hostility • Watch for erosion of norms |
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Leader tasks
--WORKING Phase-- of Group Development |
• Focus on inter/intrapersonal
• Manage group discomfort with increased intimacy |
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Leader tasks
--TERMINATING Phase-- of Group Development |
• assist in acknowledging loss, reality of the approaching end
• reviewing accomplishments & disappointments in group |
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Therapeutic Factors
(Yalom) |
• Instillation of Hope
• Universality • Imparting of Information • Altruism • Corrective Recapitulation of Primary Family Group • Development of Socializing Techniques • Imitative Behavior • Interpersonal Learning • Group as Social Microcosm • Group Cohesiveness • Catharsis • Existential Factors |
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Therapeutic Factor:
• therapeutic effect of faith in Tx model • begins Pre-Group with positive expectations, possibility for healing |
Instillation of Hope
(Yalom) |
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Therapeutic Factor:
• Sense that "I am not alone" or • "We are all in the same boat" |
Universality
(Yalom) |
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Therapeutic Factor:
• process of learning that others have thoughts/feelings similar to one's own • challenge to internalized sense of uniqueness re: social isolation • Assumption that "There is no human deed or thought that lies fully outside the experience of other people." |
Universality (Yalom)
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Therapeutic Factor:
• Didactic Instruction • Direct Advice |
Imparting of Information (Yalom)
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Mode of Imparting Information (Yalom)
• Psychoed. concepts • alter sabotaging thought patterns • structure group • initial binding force in group • assuages some natural anxiety |
Didactic Instruction (Yalom)
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Mode of Imparting Information (Yalom)
• most often between members • high frequency as predictor of group development • poss. resistance to intimate engagement • rarely benefits client aside from conveying mutual interest, caring |
Direct Advice (Yalom)
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TRUE or FALSE
Regarding Advice in Group Therapy offering Direct Suggestion is MORE effective than a Series of Alternatives |
FALSE
Offering a series of alternative suggestions is most effective |
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Therapeutic Factor:
• intrinsic benefit to act of giving • challenging deep sense of "nothing to contribute" • finding can be important to others rather than a burden • encourages role versatility |
Altruism (Yalom)
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Therapeutic Factor:
• transference reactions rooted in early relationships • Group as venue for early conflicts to be resolved • Explore/Challenge Fixed Roles |
Corrective recapitulation
of the primary family group (Yalom) |
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Therapeutic Factor:
• deliberate alterations of social behavior • permits clients to understand discrepancy b/t intent vs. impact • accomplished through open, accurate feedback re: maladaptive social Bx |
Development of Socializing Techniques (Yalom)
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Therapeutic Factor:
• clients may follow Bx of other members and/or therapist • learning through observation of others tackling problems • Vicarious/Spectator Therapy |
Imitative Behavior (Yalom)
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process by which group members benefit by observing therapy of another member with a similar problem constellation
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Vicarious or Spectator Therapy
(Yalom) |
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Therapeutic Factor:
• Importance of Interpers. Relationships • Corrective Emotional Experience |
Interpersonal Learning (Yalom)
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• re: fundamental power of human need for intense, persistent relationships
• Parataxic/Interpersonal Distortions • Consensual Validation |
Importance of Interpersonal
Relationships (Yalom) |
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Parataxic/Interpersonal
Distortions (Yalom) |
• individuals' proclivity to distort their perceptions of others, on the basis of a personification existing mainly in fantasy
• different origins than concept of transference, but operationally very similar |
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Consensual Validation (Yalom)
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comparison of one's interpersonal evaluations with those of others
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primary means of altering parataxic distortions
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Consensual Validation (Yalom)
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• telltale sign of a Here & Now Corrective Emotional Experience
• "turning point" for group member, single most therapeutic event for indiv. • usually involves another group member, not the therapist |
Critical Incident (Yalom)
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Common Types
of Critical Incidents (Yalom) |
• Conflict
• Strong Positive Affect • Self-Disclosure |
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Critical Incident involving:
• often sudden expression of strong emotion toward another member • communication is maintained and client experiences "enhanced ability to explore more deeply his or her interpersonal relationships" |
Conflict
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Critical Incident involving:
• failure to confirm fear of catastrophe, derision, rejection, engulfment • client discovered previously unknown part of the self |
Strong Positive Affect
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Critical Incident involving:
• plunging into greater involvement with group |
Self-Disclosure
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Components of a Corrective
Emotional Experience (Yalom) |
• risk strong expression of emotion
• sufficient safety in group • open to Consensual Validation • Recognizing maladaptive Bx • Ultimate facilitation of ability to communicate deeply, honestly |
