Group therapy

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    • 00:02

      [MUSIC PLAYING]

    • 00:11

      JERROLD LEE SHAPIRO: I'm Jerrold Lee Shapiro, Professorof Counseling Psychology at Santa Clara University.I've been doing group therapy, group counseling,and training groups for almost 50 years.In this tutorial, we're going to explore some of the advantagesand unique qualities of group therapy.

    • 00:37

      JERROLD LEE SHAPIRO [continued]: Group therapy is a single or, most often,two therapists working with a number of clientssimultaneously.Usually, group sizes run from six to about 12 or 13.That standard.As the population of members in a groupare younger, for example, children,or as they are more disturbed, groups are smaller.

    • 01:07

      JERROLD LEE SHAPIRO [continued]: There are a number of benefits of grouptherapy over individual therapy.Economy, of course.You have one therapist working with several clients.But there are many other benefits.One of them is altruism.If I'm suffering from low self esteem, for example,and I get to help another person,that alters not only the other person's experience,but it also counteracts my feelings of low self esteem.

    • 01:36

      JERROLD LEE SHAPIRO [continued]: In addition, and this is very important,there's a real environment.The relationship between an individual therapistand a client is a very unique relationship.It's one-sided.It's all about the client.In a group, that exists.But what also exists is other real peopleresponding to the client.

    • 01:59

      JERROLD LEE SHAPIRO [continued]: So for example, if I'm working with a person individually,and they talk about how people don't like them,or they don't seem to get along, but they seem perfectly finewith me, the only data I can work with are their reports.In the group, I can see it unfold in real time.So for example, I may see them behaving in one way toward methat is not problematic at all but Ican see other members of the group gettingvery upset with them.

    • 02:29

      JERROLD LEE SHAPIRO [continued]: This is tremendously useful in moving ahead in the therapy.Groups offer individuals opportunitiesin this cultural island to safely experimentwith behaviors and get feedback not only from therapists,but from other members.This is incredibly valuable.Another advantage is a feeling of universality.

    • 02:52

      JERROLD LEE SHAPIRO [continued]: I'm not the only one with a problem.There are other people who are quite respectable sitting herewith me who are sharing, also, difficult experiencesin their life.They're sharing the skeletons in their closet.And I always love the George Bernard Shawquote, "If you had skeletons in your closet,you may as well have them dance."That's a lovely notion in group therapy,because some of the skeletons come out.

    • 03:18

      JERROLD LEE SHAPIRO [continued]: And we can look at them and realize that we all have them.Finally, there's a tremendous opportunityfor people to get support from a large number of peopleat the same time.This corrective, emotional experience goes very farin helping people alter their behaviorand to feel better about themselves.In a group setting, people can get tremendous supportfrom other people, allowing them to feel better about themselvesand to feel a real connection with others.

    • 03:51

      JERROLD LEE SHAPIRO [continued]: This is both healing and useful in them bringing it backto their back-home life.All groups in therapy or outside of therapyfollow a natural process.The process involves preparation,which means everything it takes to getthe person into the room, transition,in which the therapists are tested so that the clients canlearn what the therapists can help them withand how much they can help, treatment per se, whichis the therapy per se, and finally termination,in which they get to say goodbye and have to deal with that,and also transfer the material they've learnedinto their back-home home lives.

    • 04:35

      JERROLD LEE SHAPIRO [continued]: It is essential that leaders of groupsunderstand the natural process.Interventions are always tied to what'sgoing on in the process of the group.So for example, in the transition phase,there are often tests of the leadership.There are two basic tests, how much can they handleand what doesn't belong in the group at all?

    • 04:58

      JERROLD LEE SHAPIRO [continued]: What is just out of bounds for this group?As the leader passes these tests,the clients become ready for the therapy phase which follows.Leaders who are not attuned to processand don't recognize that these tests are essential end uptrying to do therapy prematurely and end up getting very littledone in the group.

    • 05:23

      JERROLD LEE SHAPIRO [continued]: It is common these days for many groupsto follow a psycho-educational model.This means it's almost like a class during which thereis some processing of information,some chance for clients to talk about what's occurring.The big problem with psycho-education groupsis that the notion behind them isthat learning something or new trainingwill alter what the clients are experiencing.

    • 05:50

      JERROLD LEE SHAPIRO [continued]: That may be true.But what's much more powerful and what'slost in psycho-educational groupsis the focus on the process per se,on the leaders knowing where the group is, what the group needsat a particular moment, and intervening properlyin those moments.Research indicates that psycho-educational groups,for example, show some advantages over no treatment,but nowhere close to the advantageover process-oriented groups.

    • 06:27

      JERROLD LEE SHAPIRO [continued]: There are unique challenges within each phaseof group therapy.In the preparation phase, the largest challengeis screening, making sure you get the right combinationof people together, making sure there'ssome equivalence of individuals ego strength, for example.In transition, the challenge is dealingwith the tests of leadership and allowing for the groupto feel more trusting in the abilities of the leader.

    • 06:58

      JERROLD LEE SHAPIRO [continued]: In the therapy phase, the challengeis knowing how to intervene therapeutically,how to successfully help people to make significant changes.And in termination, the major challengeis being able to deal with loss, saying goodbye,and also helping people integratewhat's happened in the group into their back-home livesin a realistic way, because the group operatesunder different contingencies and isjust a different kind of interactionthan back-home life is.

    • 07:35

      JERROLD LEE SHAPIRO [continued]: Getting a group together involves careful screening.And the most important factor is equivalence of ego strength,the ability of people to function at fairly muchthe same level.You can have very successful groupsof people who are functioning at a very high level.You can also very successful groupsof people who function very poorly or with personalitydisorders.

    • 07:59

      JERROLD LEE SHAPIRO [continued]: The problem is you can't mix them,because the lowest functioning member of the groupis like the weakest link in a chain.It has much more control over how far the group can go.So it's very important to have people functioningat roughly the same level.When we do therapy, it is mandatorythat we expect that everything we say to our therapistwill be confidential.

    • 08:26

      JERROLD LEE SHAPIRO [continued]: In a group, everything we say in the groupwill be held confidential by the leaders.My experience is it will also be held relatively confidentiallyby members, but we always warn members to be cautious,because there are people there who are notin a professional contract with themand that confidentiality can be an issue.

    • 08:50

      JERROLD LEE SHAPIRO [continued]: As I've said, it's very unusual for peopleto break confidentiality but it can be quite distressingif it is.One aspect of confidentiality involves whether or notmembers are able to meet each other outside of the group.Certain groups are formed by people who know each other.

    • 09:10

      JERROLD LEE SHAPIRO [continued]: Other Groups are formed mostly of strangers.Different rules of confidentialitymay apply if it's strangers or of it'speople you're liable to run into at work,around your friendships, in your regular life.It is essential for therapists to underscore the importanceof keeping what happens in the group in the group,particularly if it's not groups of strangers.

    • 09:40

      JERROLD LEE SHAPIRO [continued]: Researcher on groups has shown that groups and group therapieshave been just as effective as individual work, sometimes moreso.There is one population that does very poorly in groupsand it's very obvious.These are people who are painfully shy.People who are painfully shy shouldbe seen individually and not in the group setting.

    • 10:06

      JERROLD LEE SHAPIRO [continued]: There are two formats for groups.One are open enrollment groups and one are closed groups.In open groups, members change from time to time.The group's population is stable for certain periods of timeand unstable for other periods of time.In a closed group, the whole group begins and ends together.For this reason, closed groups tend to be short term, usuallyaround 10 to 12 sessions.

    • 10:32

      JERROLD LEE SHAPIRO [continued]: I do almost entirely closed groups.I learned this very early from colleagues who would say,my group is going great right now.The population has been stable for four weeks.It occurred to me, why not make the populationstable from the beginning.The disadvantage of the closed groupis, of course, you don't get to deal with natural new memberscoming in, and members leaving, and dealing with those issues.

    • 11:00

      JERROLD LEE SHAPIRO [continued]: The advantage is that everyone goes through things togetherand they have tremendous support for each other,potentially, even after the group has ended.All the groups that I do have more than one leader.There are a number of reasons for this.But the most important one is, whenyou think about an interaction between one individualand a therapist, you have to focuson each of those individuals and the interaction between them.

    • 11:26

      JERROLD LEE SHAPIRO [continued]: That's three.If you add another person, we're up to six.In a group of eight, it's incalculable, at least for me,but there's so much going on that it's incredibly valuableto have more than one person observing the process.It also requires that you focus on process rather thanindividual interactions, because individual statementsand interactions are just too many to dealwith at the same time.

    • 11:60

      JERROLD LEE SHAPIRO [continued]: Effective group therapists are those who are well-trained.This involves being a member of a group,having classes on groups, co-leadingwith a senior person, and, finally,co-leading with a junior person or an equal.It's a long process.It's a difficult thing to do.

    • 12:20

      JERROLD LEE SHAPIRO [continued]: It's a form of therapy that requires unique sensitivitiesand it also involves training.And unfortunately, that training isnot present in many universities today.The modal number of graduate coursesin psychology and psychiatry, for example, is zero.

    • 12:43

      JERROLD LEE SHAPIRO [continued]: People are trained in individual therapyand then expected to do groups.And almost every trainee has to do groups right out of the gun.The training of doing individual therapy with an audienceor running a class is simply not aseffective as learning about the process of groups.

    • 13:13

      JERROLD LEE SHAPIRO [continued]: In this tutorial, we've talked about the advantagesand some questions about group psychotherapy.We've also talked about the importance of processin a group and how a group trajectorymust be attended to by the group leader.[MUSIC PLAYING]

Group therapy

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Abstract

Group therapy can be beneficial for several reasons within the context of psychotherapy, psychology and psychiatry. Group therapy allows patients to interact with one another, resolve issues within a group, and think in altruistic ways. Though group therapy has proven to be as beneficial as individual therapy, (if not more so,) it is often under-examined as an important component to the overall practice of counselling psychology and thus many therapists do not receive group counseling training.

SAGE Video Tutorials
Group therapy

Group therapy can be beneficial for several reasons within the context of psychotherapy, psychology and psychiatry. Group therapy allows patients to interact with one another, resolve issues within a group, and think in altruistic ways. Though group therapy has proven to be as beneficial as individual therapy, (if not more so,) it is often under-examined as an important component to the overall practice of counselling psychology and thus many therapists do not receive group counseling training.

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