GROUPPSYCHOTHERAPY

Group therapy is a special form of psychotherapy in which a

small group of individuals who share a common pathology, to a psychotherapist

professional, to help each other individually and mutually. This form of therapy is of very common use.

widely accepted for more than 50 years.

We have all been raised in groups, whether in family or school life, like

workers or as citizens. We develop as human beings always in

group environments. Group psychotherapy is no different. It provides a context for

share problems or concerns, better understand one’s own situation, and learn

together with other people.

Group psychotherapy helps a person to know themselves, and also to

improve your interpersonal relationships. You can focus on the problems of loneliness,

depression and anxiety. It helps us make important changes to improve the quality of the

life.

CHARACTERISTICS

Universality: Participation in a group provides relief to patients.

since they realize something very important: they are not alone with their problem. This

universality breaks with loneliness and isolation when the components can

to observe that there are other people with problems, problems that can even be

similar.
 Group cohesion: In a cohesive group, members accept and support each other.

mutually and build meaningful relationships with each other. This cohesion

provides stability, commitment, and participation. Without it, therapy is hardly possible.

group can work.

Collaboration: The help provided among group members can turn into

a great therapeutic instrument; patients can improve their self-esteem by

to observe that your experience is useful for other people.

Topic of 'here and now': It is important to focus on this concept to achieve

let emotions flow and not be spoken only from the recounting of events

lived. The here and now helps to feel and share with the rest of the participants.

BACKGROUND

Dr. Joseph Pratt, a physician from Boston, in 1905 gathered all his patients from

tuberculosis together to have weekly exchanges of opinions in group and found

that those sessions seemed to favor mutual support, alleviating depressions and

they diminished the feeling of isolation. Moreno, who is considered the best for

Developing psychodrama, he was the first to use the term 'group therapy' in 1920.

group treatments were considered ineffective until World War II. The

numerous neuropsychiatric casualties due to the war forced the governments of

USA and England are finding the most efficient and economical way to treat those veterans.

Since then, the field of group therapy has grown rapidly and currently

It is applied in different clinical frameworks for various types of problems.

THEORETICAL FOUNDATION:
 There are some models that have provided important assumptions in favor of the

practice of group psychotherapy. Among which can be mentioned:

The medical model

As mentioned earlier, the first group psychotherapist to appear

cited several times in the literature on the subject is Joseph Pratt in 1905. He used the model

educational/inspirational for the moral treatment of patients with tuberculosis in Boston, in

the early years of the century, and Trigant Burrow was the first to apply psychoanalytic ideas

to the groups in 1920. Pratt was interested in the effects of social stress on tension

psychological and used group methods, which had many ancient ideas in common

with therapeutic communities. During the following two decades, the experiences

group activities were reported by numerous practitioners including E.W. Lazell, L. Cody

March, Louis Wender, and Paul Schilder.

The psychodynamic model

In the post-war years, there were various ways to apply the principles.

Psychoanalytical. In the United States, S.R. Slavson was the promoter of the development of therapy.

group in the New York area, where he led groups of children in the years of

pre-war. Their organizational efforts led to the formation of the American Group.

Psychotherapy Association in 1942, among its ideas about the application of work

Individual psychoanalytic therapy to group therapy emphasized the importance of understanding the

emotional dimensions in the relationships of each member for the therapist, and for the

group of members. The basics of this utilization were the analysis of this group of

relationships through the experiences developed in the current neurotic behavior of the

early childhood experiences.

 Group behavioral therapy

It was Arnold Lazarus who, after emigrating from South Africa to England, emigrated to the

United States, and create a movement that will work together on all the disorders.

behavioral issues that could have been addressed within this. The followers of this movement go

to apply this method to sexual disorders, and it should be noted the work in this regard of

the prominent H.S. Kaplan, when addressing disorders of female frigidity and male impotence in

group.

Gestalt therapy in group

The Jewish-German emigrant, psychiatrist and psychoanalyst, in the United States Fritz Perls, is

a flag bearer of gestalt group therapy, particularly developed in the United States

United. The success of its principles such as the 'here-now', the emphasis on experiential aspects for example,

it is so big that a group of authors take the same ones and incorporate them into their current, like

it is the case of Yalom and his interactional group.

Transactional Analysis

The Canadian psychiatrist and psychotherapist, based in California, Eric Berne, will propose

about the 60s, its theory of Personality, Psychotherapy, and Communication, the

Transactional Analysis, which will also become a group tool, that will be

used later by some followers in particular fields of psychotherapy

group as is the case with Alcoholism, and other disorders, where it constitutes an instrument

useful for patient management and education in the disease that is currently

magnificently useful.
Group psychotherapy has emerged from previously established therapeutic models.

mentioned, which developed this modality transcending from individual practice

in group settings. Currently, the therapeutic models that use it the most are Gestalt,

Cognitive-Behavioral and Transactional Analysis.

BASIC PRINCIPLES OF GROUP THERAPY

Each group session is a personal and exclusive experience. Every session is

unique. It takes place only once and cannot be repeated.

Group situation. The first meeting of the group with the therapist is decisive.

empathy begins with the discussion of immediate and current problems; the

Past problems are only discussed if they stem from the current ones.
Group treatment medium. The patients sit in a circle and the therapist in

the center, or the patients sit on the floor informally, in such a way

that they can see each other when talking.

Therapeutic interaction. This depends on a favorable sociometric selection of the

members, that is to say, therapeutic success will be achieved if a good selection is made

sociometric.
Confrontation with real life. Therapeutically, psychodrama is closer to the

real life compared to group therapy, as in the latter the patient

You can express what you feel, but without dramatizing; catharsis can be presented more.

not the acting.

Production in the here and now. The most impressive experiences of the past.

they acquire expression through present experiences.

 Spontaneity. It is the production of material in a spontaneous and improvised manner,

what people do within the group, without putting up resistance to their memories and

experiences.
Integration. Throughout the therapeutic sessions, integration increases.

group psychic through the fusion of its members. The group reaches a moment in

that all the members become aware of the latent feelings of a patient and 10

they share.

APPLICABILITY OF GROUP THERAPY

The therapist is the one who assesses the incorporation of a person into group therapy based on

their individual characteristics and needs. Of course, for some patients, the

group therapy will not be a good tool, but that will also depend on the moment of

therapeutic process in which they are; a patient may require X sessions

individuals, and after a while it may be the right time to join group therapy.

Even so, we always recommend starting with individual therapy and later

continue with a group therapy; even once group therapy has started, it can be very

It is interesting to hold individual sessions to discuss specific topics and organize.

ideas.
Among the inclusion criteria for a psychotherapy group, the ability to stand out

to carry out group tasks, the motivation to participate in the treatment, the compatibility between

the patient's problem areas and the group's objectives, and as we have

mentioned, the commitment to attend.

In psychotherapy groups, heterogeneity is precisely what makes things interesting.

group and enhance the therapeutic potential. The interaction between different styles of

personality, ages, origins, and even issues, will facilitate different perspectives and

opinions of those situations lived and exposed by each group member, always
from respect and constructive criticism. Nevertheless, there are groups that address issues

very specific such as addictions or eating disorders, and in them the

components do have the same profile.

TECHNIQUES USED IN GROUP THERAPY

Creation of the mask

A technique frequently used in group therapy is to have each member of the

group create a mask that feels like it represents your emotion. These masks can be

sculpted with clay and painted or can be drawn on the back of paper plates and

colored. Once the masks are finished, everyone comments on their response

emotional visceral to the masks of others and that is compared to the emotions that he

creator was trying to represent. This helps the group members to express the

emotional turbulence as well as to examine the difference in perception among everyone regarding

each mask. This tactic is frequently used in anger management groups.

roleplay game

Role-playing games are an acting exercise frequently used in an environment

of group therapy. A member of the group can represent someone from another's life.

group member to give the opportunity to practice effective communication. For

For example, if a group member has anger issues with his wife, another member of the

group will represent his wife so that she can communicate effectively without a

rabid response. This is also useful if a group member is preparing to

confront an abuser, ask for a raise, or experience any other significant conversation

emotional importance.

Write stories and share them

 Another group exercise involves each member writing a story about themselves and

his life and then read it aloud for the group to listen and discuss. This is beneficial

for those group members who are not as talkative as others. It allows for

they should pre-write, which can make it easier to communicate difficult matters to introduce in

a traditional conversation. This allows members to share their creativity

in addition to thoughts and emotions, and this can help build good relationships in

the group.

DEVELOPMENT OF GROUP THERAPY

At the beginning of the treatment, and as much as possible throughout its development, the

therapist interventions should be few and especially succinct and clear given the high

level of anxiety that this system can generate at the beginning, the tendency to regression in

this type of situation and the lack of practical knowledge of the coordinator's role. When the

therapist adopts this approach, the patients integrate cognitively and

emotionally better than when the therapist adopts a passive attitude. Communication

Transparent highlights that patients who establish close therapeutic alliances

those with their therapists tend to show greater improvement than those whose relationship with their

therapists are not that good.

The written record of the session by the observer, in addition to its implications

In research, it is important as it serves as a memory of the process and stimulates the

consideration by patients of a range of involvement of the team with their

treatment. In the event that there is no possibility of simultaneous registration, it is recommended

summarize the session as soon as it is finished. These records or protocols of

observations must include the date, the session number, the names of those present and those
absent, the distribution in the group room, and a brief summary of the interventions and

most significant interactions, as well as the emerging qualities and the contents

group activities as a whole.

DIVISION OF SESSIONS

1) Initial sessions

The group members conduct a search for those aspects that make them

equal; this form of communication is established through homogeneity or analogy

symptomatic that motivates their presence in the room, and will determine the social phenomenon of the

cohesion. The group attempts to elucidate and clarify the degree of belonging of its members to

system as a preliminary form for establishing the basic trust necessary to pour

this type of information.

Individuals feel the repetition of the tension that signifies the attempt to preserve.

an individuality and the desire to merge it, at the same time, with a group identity. The team

therapeutic evidence shows a change in the attitude and therapeutic disposition of some

patients had in the preparatory individual interviews, with the resistances that were

they manifest at the beginning of the process.

The spatial location of patients (stays and rotations according to the axis

represented by the location of the therapists) stabilizes in the first sessions of such

luck that it seemed as if each patient had a tacitly assigned spot. The degree of

the group's focus on the therapeutic task does not appear manifestly homogeneous in

both patients with inhibited roles maintain a silent cooperation that the team

therapeutic must be respected.

In the opening, development, and closing of the first sessions, they stabilize and, therefore, they
they highlight the talkative and silent roles following a relatively fixed sequence in

function of the aforementioned group moments. The abandonment of psychotherapy

during the first sessions it is a frequent and inevitable fact that correlates, as

It has already been pointed out, with the quality of the previous selection and preparation. The concern for

abandonment, or keeping a patient at any cost, can have a negative effect already

which can undermine trust among most members. It is the coordinator's role to encourage

to talk about the phenomenon of a member's departure, the confusion about the

composition and the fantasies that this performance has awakened.

Intermediate sessions

The roles assumed within the group are defined progressively and qualitatively based on

from the needs for relaxation or concentration on the task. Similarly, arise

roles as obstacles to it, such as: the 'inhibited' or the 'co-therapist'. When

the tendency to assume a certain role by patients repeats, the therapists

they should try to avoid this stereotype through the analysis of the phenomenon since, in

definitively, it is founded on obstructive and resistant mechanisms, both in what is

refer to the group as to the patient.

The very interaction and synergy that arise from the group situation allow a

progressive decrease in the rigidity of defenses, and therefore, of the vicious circles or

unproductive repetitions in the group. When there is difficulty expressing feelings.

latent, the 'performance' usually appears, this mechanism can be considered as a

displacement of behavior from one situation to another or the direct transformation of affect

in behavior without mediating cognitive processes and, therefore, susceptible to reduction through

the framing, the content analysis, and the group set.

 Some patients express objections and resistances to entering the group: in the

inhibited and anxious, the concern is often related to sibling rivalry that is

expresses, when the group process is advanced, due to the feelings of guilt involved

in it; for the same reason, it is perhaps the group an ideal place to provide the possibility

from a corrective emotional experience. Patients with a hostile or ambivalent relationship

with authority figures, who often show a preference for this type of therapy,

They will try to rival therapists by questioning their norms and procedures.

One of the most recurring defense mechanisms is projection, through which the

patients attribute to others, including the therapeutic team or the institution they represent, the

unaccepted impulses within themselves.

The problem of transfer in the group places us in a broader field than in

the dyadic relationship but also much harder to isolate and process. The reaction

Transference in the group must be identified, analyzed, and worked on as a factor.

coadjutor to the breaking of the biographical inertia that psychoterapy implies; this work,

it should be initiated in the intermediate phases of the group process.

Final sessions

The therapeutic team begins to regularly remember the remaining sessions of

Countdown treatment, in order to avoid the denial of this fact and

to bring to your consideration with all its implications.

This is usually the group's most intense work period, as by this point it must

to be completely settled regarding the composition of its members and to have a

clear internal representation of each of the others and, if the work in its minimum terms

it has been completed correctly, the awareness of termination and the need to
exploitation of the time that each of the components has lived as lost.

In the last four sessions, independence from the therapist is evident.

insofar as the internalization of their technical role and attempt to overcome dependence that

inevitably implies the termination of the process and the search for the difference and

individuation with respect to peers. At the same time, feelings of

impotence and rage that awakens the awareness of the end through themes related to the

illness, separation, unrequited love, and death.

In the last two sessions, encounter projects are often formulated as fantasies.

intended to overcome the ending and postpone the inherent mourning. Fantasies, in

these meetings are usually segmented and, unless there are exceptions, it is not common that

endure.

In parallel, and generally at the end of the last two or the last session, the

Patients often ask about the continuity of treatment; this emerging one is returned.

to the group with the sole instruction of individual evaluation afterwards, once it has settled down

group process.

BENEFITS OF GROUP THERAPY

Just like individual therapy, group therapy can help with the

majority of people. For example in situations of:

Difficulties in relationships with other people

Impact of chronic or severe diseases

Situations of depression or anxiety

 Death or abandonment of a loved one

Coping with traumas

Personality disorders

In addition, the group fulfills a series of functions:

Satisfy feelings of belonging. The information that the person receives in the

group is much more than what one can receive from a therapist (because in the interview

individual solo is found him and the consultant): the remaining members enrich the

experience.
Facilitate the enrichment of resources to address the different situations of the

life.
As identity is determined by identificatory processes and place

relational occupied in relation to others, the group phenomenon allows for construction and

consolidation of it.
Enhance the possibilities and skills to achieve the pursued goal
Promotes the exchange of norms, values, and rules. The group facilitates the achievement of a

cosmovision and universality in relation to the appreciation of problems, what

it allows subjects to be less self-centered and stop seeing themselves as

victims
It allows for emotional and affective development by facilitating the construction of social ties.
It favors the personal questioning of stereotypical attitudes or beliefs.

illusory.
It allows putting into words lived situations enabling their demystification.

removing the tragic connotation from them.

Self-imposed obstacles are discovered by elaborating fears and doubts.
ADVANTAGES OF GROUP THERAPY

Compared to individual therapy, group therapy has some advantages:

The support of the other group members and the therapist

The reduction of the isolation in which many people who go to therapy live.

The opportunity to observe psychological, emotional, and behavioral responses and

the interaction between the people in the group

The lower economic cost