CBH Group Therapy

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    • 00:06

      [Cognitive Behavioral Therapy Group Therapy]

    • 00:11

      MARK PFEFFER: My name is Mark Pfeffer.I'm a licensed psychotherapist and directorof the Panic Anxiety Recovery Centerof Chicago. [Mark Pfeffer, Psychotherapist, Directorof Panic Anxiety Recovery Center]The type of therapy that I do is cognitive behavioral therapy,both individually and in group settings.This group session that we're in todayis a support group for the improv anxiety class.And in this group, we actually teach peoplecognitive behavioral therapy.

    • 00:32

      MARK PFEFFER [continued]: We give them opportunities to do some strategic improvactivities, which have social anxiety themes customizedfor the very reason that they're here.Cognitive behavioral therapy is a form of psychotherapy thatfocuses on the here and now.It's problem focused, short term,and puts the client in the driver's seat.The goals of this class is for the students

    • 00:53

      MARK PFEFFER [continued]: to be able to apply the principlesof cognitive behavioral therapy in their real life,and also have some rehearsal and practice in the session.So there's really two benefits from beingin this room because you get the actual practice in vivoon the spot, but also they get the skills and the coaching

    • 01:14

      MARK PFEFFER [continued]: to be able to apply this in their real life.The theory is that if we can change the way someone thinks,we can change the way they behave.The way we start the improv for anxiety support groupis individual check-ins.So we go around in a circle.Everyone reports on highs and lows in their week.And it kind of sets the tone for the rest of the evening.

    • 01:36

      SPEAKER 1: I started a new job a few months ago,and that definitely has had some challengesgetting used to the new people and feelinglike you're on display a lot.

    • 01:46

      SPEAKER 2: I've been at the same job for 20 years.I have a beautiful condo.And every time, I'm like, oh I reallyshould go and move somewhere.Oh, but I have my house.So you can see where this is going.And last Wednesday I woke up in the morning,and I said, you know, I've got to do something pretty drastic.

    • 02:08

      SPEAKER 2 [continued]: And I put my condo, my home, on the market.

    • 02:11

      MARK PFEFFER: I love it.

    • 02:12

      SPEAKER 2: And I'm going to see what happens if I'm notattached to something.And I'm hoping that then I look for some jobs that I love.

    • 02:25

      MARK PFEFFER: The other thing we dobefore we do some strategic improv isjust some basic warm up.And we may do something like zip,zap, zop, or pass the clap around the room.And get people not only warm in terms of the check ins,but warm physically.

    • 02:49

      MARK PFEFFER [continued]: And then after we do the warm up,we go into what we call strategic improv.And in strategic improv, we take, in this casesocial anxiety themes, and come upwith exercises that may be improvisedfrom the typical exercises they do in improv class.So these are more geared towards a very specific thingthat people came to the group for.

    • 03:10

      MARK PFEFFER [continued]: We actually go beyond some of the typical gamesthat we use in improv to customize itmore for social anxiety themes.Everyone in the demonstration groupwill have social anxiety disorder.And so we try to gear the games towards the peoplewho are participating.And that's a fun opportunity, but it's also challenging.

    • 03:33

      MARK PFEFFER [continued]: And you'll see people really having fun,but they're also feeling some anxiety at the same time.

    • 03:39

      SPEAKER 3: So again, in being the student of our own anxiety,think about that.Number one, was it ever difficult to raise our voice?Was it ever difficult to sometimes have moreaffect in our voice, in the way that we were speaking?Was it difficult to make mistakes,to fail confidently, to know we might be taking chances,to be anticipating receiving something and needingto live up to a standard?These are some things that are kind

    • 03:60

      SPEAKER 3 [continued]: of part of this activity that we can think about,but you all did fail confidently,and you all failed a lot.But actually, this was the most I'veseen a group fail this activity [INAUDIBLE].

    • 04:08

      SPEAKER 4: That was great.Well, we're really proud of her.[APPLAUSE]

    • 04:12

      SPEAKER 3: Sometimes an activity like this can be difficult.Because the bottom line is, we live in a worldwhere we are not the only person in the world.We live in a world where we have to collaboratewith other people.And an exercise like this forces you to take that step back.

    • 04:25

      MARK PFEFFER: After the strategic improv,we set aside time for people to do solo exposures.And that's where they would come up in front of the groupand do whatever they want to do.They could sing a song.They could give a speech.They could do a role play of someone owes them money,and they want to practice a confrontation.They could do that.So it's a very intense experience.

    • 04:46

      MARK PFEFFER [continued]: And we jam pack a lot of information and skill buildingin a two hour session.Well, let let's try to do this.Because she's going to play the part that'sgoing to be a little difficult for you, right?So I want you as your exposure not to default to the old you.I want you to default to the new you.And so whatever she says, you're going to be able to manage.

    • 05:07

      MARK PFEFFER [continued]: Because we're in a very supportive improv environmentright now, so you could take on a role of the superheroif you want to do this role play if you need it.

    • 05:16

      SPEAKER 2: So what did you think?Is it something that you'd like to buy?

    • 05:21

      SPEAKER 5: You know, it's a nice place.I have some concerns about the price.I do feel like the asking price is a little much.

    • 05:29

      SPEAKER 2: I think mine is priced very, veryappropriately.

    • 05:33

      SPEAKER 5: How long have you been in this unit?

    • 05:35

      SPEAKER 2: 10 years.

    • 05:36

      SPEAKER 5: OK.And why are you leaving?

    • 05:38

      MARK PFEFFER: Did you feel that therewas anything that was valuable right on,or did you think you bombed?Do you think you failed?

    • 05:46

      SPEAKER 2: No, I didn't think I failed,but I would just like to be able to do it with just no anxietyand just be like, hey, go by my neighbor's place.It's a real dump.

    • 05:59

      MARK PFEFFER: Well, what did you learn?

    • 06:01

      SPEAKER 2: It actually was really helpfulbecause I think in the next couple weeks,if somebody is a realtor says well,you know, this-- and I think I mightfeel more confident saying, you know what?There's two other units.Mine is very reasonably priced.They really-- go tell them to buy one of those.

    • 06:20

      MARK PFEFFER: One of the things you can consider doingis just start doing some visual imagery of these realtorscoming, and you just picture Annie, that type of thing,and stand up.And I would even do something with the volume of your voice.I almost want you to get bigger than you are.Currently we're doing research with the University of Chicago.And one of the variables that we're looking at

    • 06:42

      MARK PFEFFER [continued]: is the power of the ensemble, and that justmeans the power of the group.And the fact that these people are being so vulnerableby doing the improv in some of these group exercisesis a magic that takes place that I've rarely seen.It's not just a regular group, but Iwould refer to it as a tribe.

    • 07:03

      MARK PFEFFER [continued]: And that's really the term that Iwould like to use because they feelthat they're part of a new tribe,and it happens instantly.Even the first day of class, they start getting together.And just another note about tribes.The reason why the people in this demonstration are hereis because they have this exquisite sensitivity

    • 07:24

      MARK PFEFFER [continued]: to scrutiny from others.And this scrutiny from others is not just being shy,but it's the fear of being rejected by the tribe.And no one knows why people have social anxiety.But if the theory is true, the fact of someonebeing afraid of being rejected by the tribe,they're afraid that they'll lose some very basic things, very

    • 07:45

      MARK PFEFFER [continued]: primitively, unconsciously.Food, shelter, sex, all that good stuffthat are available to us in the tribeare now no longer available to people rejected.Why else would people with social anxietyrefuse promotions, not get in relationships,not get out of relationships, and restrict their lives,unless something very big was at stake?

    • 08:06

      MARK PFEFFER [continued]: And that's a very important pointto consider when we look at the group dynamic,is because that's what the group dynamic iswhat gets these people through the verydifficult times of recovery.All right, guys.[APPLAUSE] Thank you for this day.You guys enjoy this.

    • 08:22

      SPEAKER 6: Thank you, Becca.

    • 08:24

      BECCA: Thank you, guys.

    • 08:26

      SPEAKER 7: Thank you, guys.

    • 08:29

      SPEAKER 8: Thank you, guys.

    • 08:30

      MARK PFEFFER: I like group therapybecause it gives me access not to just my repertoireof knowledge, but five or eight other people who are nottherapists, but they've lived the life of anxiety,and they have something to say.And at the end of the day, I learn-- every time Ido a group, I learn something.

    • 08:51

      MARK PFEFFER [continued]: So I think there's a lot of justificationfor using a group.And that's just one of them.I thought it went very well.I think people were feeling comfortable to takea risk, being vulnerable.They not only shared their concerns and their worries,

    • 09:13

      MARK PFEFFER [continued]: but they also were able to participatein some strategic improv, also do some individual exposures,and ending up the evening with some complimentsand ideas of what they learned, and itwas a very successful evening.

CBH Group Therapy

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Abstract

Mark Pfeffer discusses the use of cognitive behavioral group therapy with social anxiety clients. He provides tips for using cognitive behavioral methods to work through everyday situations.

SAGE Video In Practice
CBH Group Therapy

Mark Pfeffer discusses the use of cognitive behavioral group therapy with social anxiety clients. He provides tips for using cognitive behavioral methods to work through everyday situations.

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