Group Psychotherapy
A therapy group reproduces each member’s characteristic way of relating, which can then be examined and altered in vivo with the feedback of several people rather than one, through a set of therapeutic factors that no individual therapy can supply.
The group is a social microcosm. Whatever a person does out there, they will eventually do in here.
Who built it
Irvin D. Yalom
Stanford psychiatrist
Identified and researched the therapeutic factors, established the here-and-now focus as the group’s central discipline, and wrote the field’s standard text.
Interpersonal groupS. H. Foulkes
1898–1976Psychoanalyst, London
Group analysis: the group matrix, and the conductor rather than the leader. The dominant European tradition.
Group analysisWilfred Bion
1897–1979Analyst, Tavistock
Basic assumption groups — dependency, fight-flight and pairing — as unconscious group-level defences against the work task.
Tavistock
Theory of personality
Group therapy assumes that psychopathology is substantially interpersonal, and that a person’s characteristic relational patterns will inevitably appear in any sufficiently free social setting. The group is therefore not a cheaper way to deliver individual therapy; it does something individual therapy cannot.
Yalom’s therapeutic factors
| Factor | What it does |
|---|---|
| Universality | The discovery that one is not uniquely defective. Frequently the most powerful early factor |
| Instillation of hope | Seeing others further along |
| Imparting information | Education and advice, mostly less important than members expect |
| Altruism | Being useful to someone else — for demoralised members, often the decisive experience |
| Corrective recapitulation of the primary family group | The group as family, with the patterns available for revision |
| Socialising techniques | Learning social skills through feedback |
| Imitative behaviour | Modelling |
| Interpersonal learning | The central factor: feedback about one’s impact, and the chance to try something different |
| Group cohesiveness | The group equivalent of the alliance, and the precondition for everything else |
| Catharsis | Emotional expression — necessary but insufficient without cognitive integration |
| Existential factors | Confronting mortality, responsibility, isolation and meaning together |
Theory of psychopathology
The group operates on the social microcosm principle: given enough time and freedom, each member will recreate in the group the interpersonal world they inhabit outside it — including the parts they would never report accurately.
Theory of change
- 1The member enacts their characteristic pattern in the group.
- 2Other members respond, and their responses are made available as feedback.
- 3The here-and-now focus turns the events of the group into the subject matter.
- 4Self-reflection: the member considers what they contributed to the response they received.
- 5They try something different, in the group, with immediate feedback.
- 6The change transfers outward.
Key concepts
The vocabulary you need to read the literature and to be understood in supervision.
Where it sits in the transtheoretical grid
Which change processes the system leans on, and at what level of content it aims.
- Helping relationship
Being open and trusting about problems with someone who cares; the relationship as vehicle, and as medicine in its own right.
- Consciousness raising
Increasing information about oneself and the problem - feedback, interpretation, education, observation.
- Social liberation
Increasing the alternatives available in the social environment; advocacy, empowerment, changing conditions rather than persons.
- Catharsis / dramatic relief
Experiencing and expressing affect about the problem, whether by corrective emotional experience or by evoking what has been avoided.
- Self-reevaluation
Appraising how one thinks and feels about oneself with respect to the problem; values clarification.
- Current interpersonal conflicts
- Intrapersonal conflicts
- Symptom & situational problems