880-Yalom: The Theory and Practice of Group Psychotherapy – Flashcards
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Instillation of hope Universality Imparting information Altruism The corrective recapitulation of the primary family group Development of socializing techniques, Imitative behavior Interpersonal learning Group cohesiveness, Catharsis Existential factors
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Eleven therapeutic factors (Yalom's Curative Factors).
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Meaning that a group facilitator should help a client feel optimistic about the group therapy experience- that change and resolution are possible. If a client feels hopeful and has faith that the treatment of group therapy can help their individual healing, then the other Therapeutic Factors can take effect. Clients must first see that the therapist passionately believes in the therapeutic process. Similarly, when clients witness other group members transforming themselves during the process of group therapy, they become hopeful that this type of therapy can work for them as well.
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instillation of hope
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Which can also be known as psychoeducating clients. Group therapists may give instructions, advice and/or suggestions to client. Yalom (2005) says that "didactic instruction is used to transfer information, alter sabotaging thought patterns and explain the process of illness... Direct advice which provides systematic, operationalized instruction or a series of alternative suggestions on how to reach a goal is most effective." A therapist can be direct with their clients and educate them on their mental illnesses and ineffective thought patterns, providing them with a sense of reality checking. Also, information can be imparted the therapist sharing how effective group therapy can be for the psychological transformation of individuals.
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imparting of information
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meaning, the act of giving without expecting anything in return, is another of Yalom's Therapeutic Factors. If a client is given to by others, they can understand that people find them to be of value and importance. Similarly, if a client gives to another client, they can see that they have something of importance to give. Yalom (2005) notes that we receive through the act of giving and not expecting anything in return. Also, by giving without expecting anything in return, we become absorbed in someone outside of ourselves, thus allowing us to have space from our own issues. Like Yalom, Adler believed that "to transcend interpersonal interaction [is] to develop the feeling of being part of a larger social community. Adler suggested this to be the most important of all social attitudes, as it inhibits egocentrism while promoting social interest (Mosak, 2000)." Group therapy is fitting venue to practice altruism, as clients express such vulnerable parts of themselves, which can inspire other group members to support them freely.
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Altruism
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Yalom says that the majority of psychotherapy clients had unsatisfactory experiences in their first, and most important group- their primary family. The group therapy setting can give clients a chance to correctively relive early family conflicts, and relationships that inhibited growth. Yalom says, The therapy group resembles a family in many aspects: there are authority/parental figures, peer/sibling figures, deep personal revelations, strong emotions, and deep intimacy as well as hostile, competitive feelings.... Members will interact with leaders and other members in modes reminiscent of the way they once interacted with parents and siblings. The group therapy setting is a safe place to work out unfinished business with family members from childhood. This is because old family issues will often resurface in the group setting, and problems can be worked through with therapists and other group members, serving as corrective emotional experiences.
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corrective recapitulation of the primary family group
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an important Therapeutic Factor that occurs in the group therapy setting. Yalom says that "social learning the development of basic social skills- is a therapeutic factor that operates in all therapy groups..." Therapy groups help clients obtain sophisticated social skills, as they learn how to process emotions, resolve their conflicts with others, to be helpful, less judgmental of others and more empathetic. These deeper social skills are indirectly learned by getting feedback from other group members and from group leaders. These skills, when taken out into the world at large, can help clients greatly with in their relationships with others.
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development of socializing techniques
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says that those in group therapy will try out parts of the therapist's and other member's behavior to see what fits them well. When clients experiment with the behavior of others, they find out who they are, and who they are not. "Clients during individual psychotherapy may, in time, sit, walk, talk and even think like their therapists. There is considerable evidence that group therapists influence the communicational patterns in their groups by modeling certain behaviors, for example, self disclosure or support..." Much like the development of socializing techniques, imitating the behavior of the therapist and other group members can teach clients great skills that can be used in their lives outside of therapy.
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Imitative behavior
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meaning that interpersonal relationships are highly important, they are ground for experiencing corrective emotional experiences, and the group is a social microcosm of the members' external lives. Yalom says, From whatever perspective we study human society- whether we scan humanity's broad evolutionary history or scrutinize the development of the single individual- we are at all times obliged to consider the human being in the matrix of his or her interpersonal relationships. There is convincing data from the study of nonhuman primates, primitive human cultures, and contemporary society that human beings have always lived in groups that have been characterized by intense and persistent relationships among members and that the need to belong is powerful, fundamental, and pervasive motivation. Interpersonal relatedness has clearly been adaptive in an evolutionary sense: without deep, positive, reciprocal interpersonal bonds, neither individual nor species survival would have been possible (Yalom, 2005). As humans, we are interdependent on each other in many ways for our species survival. Yalom notes that no one can transcend the need for human contact, as it is in our evolutionary make-up. Members experience corrective emotional experiences in group by expressing their emotions to other group members and taking these risks in a supportive and emotionally intelligent environment. These types of corrective emotional experiences help individuals interact with each other more deeply and honestly.
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interpersonal learning
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Therapeutic Factor, allows members to feel the warmth and comfort of being part of a group. They feel like they belong somewhere, they value the group and feel valued by the other members, they feel unconditionally accepted and supported by the group members. Yalom states that for the other Therapeutic Factors to function at the optimal levels, a strong group cohesiveness must be present. Marmarosh, Holtz and Schottenbauer (2005) say, In his theory, Yalom (1995) described cohesiveness as the primary curative group factor in group therapy, arguing that it facilitated greater collective self-esteem, hope for the self, and well-being. He described cohesiveness as the 'necessary precondition for effective therapy,' and he argued that the experience of being in cohesive group enabled group members to engage in the necessary self-disclosure and the personal exploration that is the hallmark of effective therapy. If group members feel connected to one another and there is a group cohesion, then they will try harder to influence other group members, be more open to be influenced by other members, be more willing to listen to other members, be more accepting, feel a greater sense of security, a relief from tension in the group and will self-disclose more.
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Group cohesiveness
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Therapeutic Factor that occurs when an individual can express their deep emotional feelings and experience a release and healing. Merely having a conscious awareness of repressed feelings and experiences allows for their release. If there is a strong level of cohesiveness in a group, the support of others members can help facilitate a powerful cathartic experience for a member having an intense emotional release. It can also be cathartic for other group members to witness someone having an intense emotional experience, as they can relate to it and grow by sitting with them in their emotional release.
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Catharsis
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the ability to simply be with others as part of a group. Existentialism is a psychological and philosophical theory that recognizes that life can be unfair and unjust at times, that there is no escape from pain, that no matter how close we get to other individuals we are ultimately alone, and that there is no escape from the inevitability of death. When an individual can face the basic issues of life and death, they can life more fully and honestly in the here and now, not being caught up in trivialities. Also, individuals must take complete responsibility for how they live their lives, no matter how much guidance or support they receive from others. In a study done on older women (McLeod & Ryan, 1993), existential awareness was seen as the most important Therapeutic Factor by members of the group. This may be because the basic issues of human life, such as death and isolation, become more important as we age and get closer to our individual deaths.
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existential factors
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Present Clients with many diverse ways to facilitate change in their individual lives. Group therapy offers many forms of interpersonal learning and growth that cannot exist in individual therapy, and thus it can be an important adjunct or substitute for those struggling with various psychological issues.
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Yalom's Therapeutic Factors in group therapy
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that is, plunge the group into its own experience
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activate the here-and-now
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transference and transparency.
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the therapist's use of self by focusing on two fundamental issues:
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- feeling of having problems similar to others, not alone
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Universality
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- helping and supporting others
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Altruism
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- encouragement that recovery is possible
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Instillation of hope
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- nurturing support & assistance
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Guidance
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- teaching about problem and recovery
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Imparting information
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- learning new ways to talk about feelings, observations and concerns
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Developing social skills
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- finding out about themselves & others from the group
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Interpersonal learning
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- feeling of belonging to the group, valuing the group
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Cohesion
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- release of emotional tension
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Catharsis
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- life & death are realities
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Existential factors
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- modeling another's manners ; recovery skills
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Imitative behavior
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- identifying ; changing the dysfunctional patterns or roles one played in primary family
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Corrective recapitulation of family of origin issues
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"intricate interplay of human experience" and that opens the pathway to therapeutic change. These eleven factors are: (1) Instillation of hope, (2) Universality, (3) Imparting information, (4) Altruism, (5) The CorrectiveRecapitulation of the Primary Family Group, (6) Development of Socializing Techniques, (7) Imitative Behavior, (8) Interpersonal Learning, (9) Group Cohesiveness, (10) Catharsis (11) Existential Factors.
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Yalom empirically identified 11 therapeutic factors based on the
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Hope is crucial to the therapy process. Groupmembers (and facilitators) need to achieve and maintain hope that change ispossible. Hope is required to not only keep clients in therapy, but "faith in atreatment mode can in itself be therapeutically effective". As the groupfacilitator, you must be able to communicate how this group approach will helpgroup members. In addition, you should attempt to capitalize on their hope inthe efficacy of this treatment approach whenever possible ( e.g. early groupsessions, reinforce positive expectations, educate when faced with negativepreconceptions, and direct attention to improvements displayed during thecourse of the group).
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Instillation of Hope
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Clients may enter group therapy with the preconceived idea that they are alone with their problems and that others do not share similar difficulties. While this is true to some extent, the disconfirmation of their uniqueness may be a powerful sense of relief. That is, clients learn that they are universally similar to one another. It is assumed as clients begin to share and learn about each others' similarities, they will become more trusting and open with each other. Your role is to aid in the development of group universality by pointing out similarities among group members. When clients present with problems or goals that are similar it is important that you indicate the universal nature of their issues. This may be most easily achieved during the first group session. As clients begin to discuss their lives, you will help the group identify commonalities in their life histories, issues and goals.
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Universality
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This therapeutic factor includes both didactic (intended to teach) instruction (e.g. psycho-education) and direct advice (by the facilitator as well as group members). In general clients in interpersonal process-oriented groups do not highly value didactic instruction or advice giving, and Yalom discourages such practices. As the facilitator, you may chose to use psycho-education or offer suggestions to some group members to facilitate their growth and improvements. However, it is recommended that you not over-use these interventions. Group members will also give advice to one another, especially in the early stages of the group. While group members typically do not find the advice of other group members as highly beneficial, advice giving
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Imparting Information:
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1. Acceptance/cohesion 2. Universality 3. Altruism 4. Installation of hope 5. Guidance 6. Vicarious Learning/Modeling 7. Catharsis 8. Imparting of information 9. Self-Disclosure 10. Self-understanding 11. Interpersonal learning 12. Corrective Recapitulation of the Primary Family 13. Development of Socializing Techniques 14. Existential Factors
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Yalom outlined and studied eleven of the therapeutic factors; students of his (Bloch & Crouch) have defined additional factors as well
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act at the level of cognition
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Interpersonal learning
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act at the level of behavioral change
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development of socializing technique
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act at the level of emotion
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catharsis
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precondition for change
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cohesiveness
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expressing their emotions to other group members and taking these risks in a supportive and emotionally intelligent environment. These types of corrective emotional experiences help individuals interact with each other more deeply and honestly.
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Members experience corrective emotional experiences in group by:
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Yalom notes that no one can transcend (go beyond) the need for human contact, as it is in our evolutionary make-up.
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As humans, we are interdependent on each other in many ways for our species survival.
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It is assumed as clients begin to share and learn about each others' similarities, they will become more trusting and open with each other.
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Universality
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Refers to this process of returning to the same issues but from a different perspective and each time in greater depth.
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cyclotherapy
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proper selection and comprehensive pretherapy preparation.
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Preventing Dropouts.
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A social laboratory and suggest that the client has the choice of making the group yet another instance of failure and avoidance or, for the first time, staying in the group and experimenting, in a low-risk situation, with new behaviors.
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group
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By attending assiduously (show great care) to early phase problems.
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Decrease premature termination
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If the therapist has done everything possible yet is still unable to alter the situation, there is every reason to expect one of the following outcomes: (1) The client will ultimately drop out of the group without benefit (or without further benefit); (2) The client may be harmed by further group participation (because of negative interaction or the adverse consequences of the deviant role; or (3) the client will substantially obstruct the group work for the remaining group members.
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Removing a Client from a Group.
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A highly effective form of psychotherapy and that it is at least equal to individual psychotherapy in its power to provide meaningful benefit.1
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group therapy
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An enormously complex process that occurs through an intricate interplay of human experiences, referred to as "therapeutic factors."
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Therapeutic change
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Are interdependent and neither occur, nor function separately.
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Therapeutic change
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Awareness of and ability to understand one's own actions and reactions. In the change process: act at the level of cognition;
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self-understanding
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act at the level of behavioral change;
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Development of socializing techniques
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The process of releasing, and thereby providing relief from, strong or repressed emotions. Act at the level of emotion;
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catharsis
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Preconditions for change.
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cohesiveness
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the therapist reinforces positive expectations, corrects negative preconceptions, and presents a lucid and powerful explanation of the group's healing properties.
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Pregroup orientation (Instation of Hope),
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a collection of individuals with a common goal -To bring about change. Usually to improve functioning in some area and to enhance self-awareness.
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A Therapeutic Group
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Can provide a healing environment where people can form and foster the types of relationships necessary to adequately face, confront, and overcome issues, experiences or other limiting challenges in their lives.
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Group
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Emphasis is placed in the "Here-and-Now" of interactions occurring in the group as a vehicle toward self-awareness and enhanced functioning as well as healing from past experiences and traumas.
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Here-and-Now
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1) Issues and difficulties a person experiences in real-life almost certainly surface within a well-structured and safe group. 2) Feedback is both given and received within this type of setting that can lead to new insights and awareness and, hopefully, new behaviors. 3) Individual differences within group members represent a cross- section of society and may facilitate the transference of issues to the group. 4) Alienation is lost and a connection with others and something beyond the individual is felt.
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Group as a microcosom of society
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1) Group provides the opportunity to be among others with whom common problems can be shared (You mean I'm not the only one who feels this way?) 2) Feedback and caring experiences are shared with others who have been through similar things. 3) New way of relating with each other are explored and experienced. 4) More points of view are present, and more variety can afford a viewpoint that better suits the need. 5) Supportive feedback can serve as a cushion for the more confrontive. Multifeedback from the group can create an environment in which defensiveness is reduced 6) It is more difficult to ignore feedback from 4, 5, or 9 other regarding a particular attitude or behavior pattern
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Commonality / Universality
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Maintaining the coping-collapse continuum. Association with members who have faced and dealt with similar struggles are a source of hope.
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Instillation of Hope
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You are not alone in your wretchedness. This sense of uniqueness is often heightened by social isolation. After being with a group, members often experience a "welcome to the human race" phenomenon. The cliche?'s "misery loves company" or "we're all in the same boat together" can be healing.
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Universality
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Didactic instruction about mental health, mental illness, and general psychodynamics. Advice, suggestions, or direct guidance about life's problems. This tends to be more beneficial for "Task" oriented groups (assertiveness groups, parenting training groups, etc.). Individuals in counseling and therapy groups seldom rate explicit information dissemination as helpful. Information is gained implicitly through interaction, experience, and observation.
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Imparting information
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Individuals not only receive help from other members, they often provide help an feedback as well. The sense of being helpful or contributing to the well-being of another is an extremely powerful and ego-building experience
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Altruism
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Family-conflicts are frequently at the core of dissatisfaction or dysfunction (in theory). Yalom suggests that many of these problematic dynamics surface within a good working group. If the group is safe and strong, these family issues can be reworked and repaired in the new "family group".
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Corrective Recapitulation of the Primary Family Group
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The development and refining of social skills is at the heart of basic group functioning and can have a dramatic impact on extra- group functioning.
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Socializing Techniques
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Close observation of other members and of the facilitator is inevitable in groups. By observing behaviors that seem to elicit positive responses and avoiding those which elicit negative responses, members can "try on" new things with some assurance of the outcome.
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Imitative Behavior
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Members receive feedback on their most intimate "way of being" with and around other people. We live in a social society with many of the successes people have dependent on how they are with others. Group gives firsthand experience with how you are with others through focus on self-awareness. This begins with Pathology Display (making explicit that which only those who know you intimately get to see).
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Interpersonal Learning
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The expression of strong emotion is healing and beneficial. Expressing strong emotion in front of other people is not a common occurrence. Most strong emotions are locked into expression during solitary moments. Letting loose around other people can lead to feelings of relief, assurance of sanity, and also an opportunity for clarification and processing.
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Catharsis-
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the development of a "we-ness" or an identity as a group is one of the most important steps a group can take. It is not enough for a group to be cohesive, but having cohesion makes it easier to take risks, engage in more substantial disclosure, and begin the working process.
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Group Cohesion
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A fundamental step in the therapy of clients burdened with shame, stigma, and self-blame, for example, clients with HIV/AIDS or those dealing with the aftermath of a suicide
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A feeling of universality is
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That is, universalâresponses to human situations and tragedies.22
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transculturalâ
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Is enormously helpful. These responses not only appeal to our common sense but, as contemporary neurobiological research demonstrates, these forms of active coping activate important neural circuits in the brain that help regulate the body's stress reactions.
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Confronting traumatic anxieties with active coping (for instance, engaging in life, speaking openly, and providing mutual support), as opposed to withdrawing in demoralized avoidance,
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may reflect a resistance to more intimate engagement in which the group members attempt to manage relationships rather than to connect. Although advice-giving is common in early interactional group therapy, it is rare that specific advice will directly benefit any client.
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advice-giving
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serves a purpose; the process of giving it, rather than the content of the advice, may be beneficial, implying and conveying, as it does, mutual interest and caring.
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Indirectly advice-giving
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a direct suggestion;
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The least effective form of advice
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a series of alternative suggestions about how to achieve a desired goal.
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Most effective form of advice.
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The belief in or practice of disinterested and selfless concern for the well-being of others: some may choose to work with vulnerable elderly people out of altruism.
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ALTRUISM
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In group therapy it is not uncommon for a member to benefit by observing the therapy of another member with a similar problem constellation.
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vicarious or spectator therapy.
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-Generally plays a more important role in the early stages of a group, as members identify with more senior members or therapists. -In itself, short-lived, it may help to unfreeze the individual enough to experiment with new behavior, which in turn can launch an adaptive spiral.
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Imitative behavior
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Employs "a relational model in which mind is envisioned as built out of interactional configurations of self in relation to others."
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Contemporary psychotherapy
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Places the client's interpersonal experience at the center of effective psychotherapy.
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Relational psychology
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Occurs in an interpersonal situation when one person relates to another not on the basis of the realistic attributes of the other, but on the basis of a personification existing chiefly in the former's own fantasy.
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Parataxic distortion
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An individuals' proclivity to distort their perceptions of others.
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Parataxic distortions
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May be considered operationally identical.
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Transference and parataxic distortion
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Emerge from a set of deeply stored memories of early interactional experiences. -These memories contribute to the construction of an internal working model that shapes the individual's attachment patterns throughout life. This internal working model, also known as a schema consists of the individual's beliefs about himself, the way he makes sense of relationship cues, and the ensuing interpersonal behaviorânot only his own but the type of behavior he draws from others.
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Transference distortions
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Shapes the individual's attachment patterns throughout life
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Internal working model
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Consists of the individual's beliefs about himself, the way he makes sense of relationship cues, and the ensuing interpersonal behaviorânot only his own but the type of behavior he draws from others.
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Schema / internal working model
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Can be further defined by its rigidity, extremism, distortion, circularity, and its seeming inescapability.
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Maladaptive interpersonal behavior
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Is the focus of a range of parent and child group psychotherapy interventions that address childhood conduct disorders and antisocial behavior.
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Improving interpersonal communication
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An adaptive modification of interpersonal relationships, and the enduring nature and potency of the human being's social needs.
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Therapeutic process
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It increases in power and effectiveness.
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When the therapy group focuses on the here-and-now
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1) The group members must experience one another with as much spontaneity and honesty as possible. 2) They must also reflect back on that experience.
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If the here-and-now focus (that is, a focus on what is happening in this room in the immediate present) is to be therapeutic, it must have two components:
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Reflecting back, is crucial if an emotional experience is to be transformed into a therapeutic one.
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Self-reflective loop,
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the group leader's and other members' contributions to each member's here-and-now experienceâas well as to the texture of their entire experience in the group.
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An intersubjective perspective acknowledges
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A key component of emotional intelligence and facilitates transfer of learning from the therapy group to the client's larger world.
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Empathic capacity
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Relationships are confusing, frustrating, and repetitive as we mindlessly enlist others as players with predetermined roles in our own stories, without regard to their actual motivations and aspirations.
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Without a sense of the internal world of others
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-Emanates from disturbed interpersonal relationships. -The task of psychotherapy is to help the client learn how to develop distortion-free, gratifying interpersonal relationships.
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I. Psychological symptomatology
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provided its development is unhampered by severe structural restrictions, evolves into a social microcosm, a miniaturized representation of each member's social universe.
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II. The psychotherapy group,
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Through feedback from others, self-reflection, and self-observation, become aware of significant aspects of their interpersonal behavior: their strengths, their limitations, their interpersonal distortions, and the maladaptive behavior that elicits unwanted responses from other people.
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III. The group members,
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The set of symptoms characteristic of a medical condition or exhibited by a patient.
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Symptomatology
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a precondition for other therapeutic factors to function optimally.
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cohesiveness
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1. The client is increasingly free in expressing his feelings. 2. He begins to test reality and to become more discriminatory in his feelings and perceptions of his environment, his self, other persons, and his experiences. 3. He increasingly becomes aware of the incongruity between his experiences and his concept of self. 4. He also becomes aware of feelings that have been previously denied or distorted in awareness. 5. His concept of self, which now includes previously distorted or denied aspects, becomes more congruent with his experience. 6. He becomes increasingly able to experience, without threat, the therapist's unconditional positive regard and to feel an unconditional positive self-regard. 7. He increasingly experiences himself as the focus of evaluation of the nature and worth of an object or experience. 8. He reacts to experience less in terms of his perception of others' evaluation of him and more in terms of its effectiveness in enhancing his own development.
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when the conditions of an ideal therapist-client relationship exist, the following characteristic process is set into motion:
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The phenomenon of "deterioration of mental efficiency, reality testing, and moral judgment that results from group pressure." Group pressure to conform and maintain consensus may create a groupthink environment. -This is not an alliance-based cohesion that facilitates the growth of the group members; on the contrary, it is a misalliance based on naive or regressive assumptions about belonging. -Critical and analytic thought by the group members needs to be endorsed and encouraged by the group leader as an essential group norm. -Autocratic, closed and authoritarian leaders discourage such thought. -Their groups are more prone to resist uncertainty, to be less reflective, and to close down exploration prematurely.
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"Groupthink"
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1. Try harder to influence other group members 2. Be more open to influence by the other members 3. Be more willing to listen to others and more accepting of others110 4. Experience greater security and relief from tension in the group111 5. Participate more readily in meetings 6. Self-disclose more113 7. Protect the group norms and exert more pressure on individuals deviating from the norms114 8. Be less susceptible to disruption as a group when a member terminates membership115 9. Experience greater ownership of the group therapy enterprise
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It has been shown, for example, that the members of a cohesive group, in contrast to the members of a noncohesive group, will:
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meaning that all these factors relate to existenceâto our confrontation with the human conditionâa confrontation that informs us of the harsh existential facts of life: our mortality, our freedom and responsibility for constructing our own life design, our isolation from being thrown alone into existence, and our search for life meaning despite being unfortunate enough to be thrown into a universe without intrinsic meaning.
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existential factors
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Existential loneliness
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primordial (exisiting from the beginning of time)
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an inability to be with others.
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social loneliness
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a state in which we marvel not at the way things are, but that they are. In this state, we are aware of being; we live authentically; we embrace our possibilities and limits; we are aware of our responsibility for our lives.
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mindfulness of being
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an event that brings one sharply back to reality and helps one prioritize one's concerns in their proper perspective.
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boundary experience
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may be thought of also as changing, evolving psychotherapy: clients change, the group goes through a developmental sequence, and the therapeutic factors shift in primacy and influence during the course of therapy.
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Dynamic therapy
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to refer to the process in which one change in a client begets changes in his or her interpersonal environment that beget further personal change.
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"adaptive spiral"
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value interpersonal learning (the cluster of interpersonal input and output, catharsis, and self-understanding) more than do the lower-functioning members in the same group. -It has also been shown that lower-functioning inpatient group members value the instillation of hope, whereas higher-functioning members in the same groups value universality, vicarious learning, and interpersonal learning.
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higher-functioning individuals
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are the sine qua non (an indispensable and essential action) of effective group therapy, and effective group therapists must direct their efforts toward maximal development of these therapeutic resources.
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Interpersonal interaction and exploration (encompassing catharsis and self-understanding) and group cohesiveness
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Is to create the machinery of therapy, to set it in motion, and to keep it operating with maximum effectiveness. -the therapy group as an enormous dynamo: often the therapist is deep in the interiorâworking, experiencing, interacting (and being personally influenced by the energy field); at other times, the therapist dons mechanic's clothes and tinkers with the exterior, lubricating, tightening nuts and bolts, replacing parts.
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The group therapist's job
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1. Creation and maintenance of the group 2. Building a group culture 3. Activation and illumination of the here-and-now
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I will discuss the techniques of the therapist in respect to three fundamental tasks:
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the norms of the group and must be aware of this function. Just as one cannot not communicate, the leader cannot not influence norms; virtually all of his or her early group behavior is influential.
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The leader has always shaped
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a set of unwritten rules or norms that determine the procedure of the group.
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every group evolves
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has norms that permit the therapeutic factors to operate with maximum effectiveness.
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The ideal therapy group
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are shaped both by the expectations of the group members and by the behavior of the therapist. The therapist is enormously influential in norm settingâin fact, it is a function that the leader cannot avoid. Norms constructed early in the group have considerable perseverance.
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Norms
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is enormously influential in norm settingâin fact, it is a function that the leader cannot avoid. Norms constructed early in the group have considerable perseverance.
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The therapist
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is the reverse of the vicious circle, in which so many clients find themselves ensnaredâa sequence of events in which dysphoria (dissatification with life) has interpersonal manifestations that weaken or disrupt interpersonal bonds and consequently create further dysphoria.
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The adaptive spiral
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is absolutely essential in the group therapeutic process.
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self-disclosure
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the leader who sets norms of interpersonal confrontation, of emotional expressivity, of self-monitoring, of valuing the group as an important source of information, is, in effect, reinforcing the importance of the here-and-now.
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THE THERAPIST'S TASKS IN THE HERE-AND-NOW
