Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry

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Psychotherapies

Group Therapy Group therapies are based on as many theories as are individual therapies. Groups range from those that emphasize support and an increase in social skills, to those that emphasize specific symptomatic relief, to those that work through unresolved intrapsychic conflicts. Compared with individual therapies, two of the main strengths of group therapy are the opportunity for immediate feedback from a patient’s peers and the chance for both patient and therapist to observe a patient’s psychological, emotional, and behavioral responses to a variety of people, who elicit a variety of transferences. Both individual and interper sonal issues can be resolved. Therapeutic factors in group therapy are listed in Table 29-5 .

TABLE 29-5. Twenty Therapeutic Factors in Group Psychotherapy Factor Definition Abreaction

A process by which repressed material, particularly a painful experience or conflict, is brought back to consciousness. In the process, the person not only recalls but relives the material, which is accompanied by the appropriate emotional response; insight usually results from the experience. The feeling of being accepted by other members of the group; differences of opinion are tolerated; there is an absence of censure. The act of one member’s being of help to another; putting another person’s need before one’s own and learning that there is value in giving to others. The term was originated by Auguste Comte (1738-1857), and Sigmund Freud believed it was a major factor in establishing group cohesion and community feeling. The expression of ideas, thoughts, and suppressed material that is accompa nied by an emotional response that produces a state of relief in the patient The sense that the group is working together toward a common goal; also referred to as a sense of “we-ness”; believed to be the most important factor related to positive therapeutic effects Confirmation of reality by comparing one’s own conceptualizations with those of other group members; interpersonal distortions are thereby corrected. The term was introduced by Harry Stack Sullivan. Trigant Burrow had used the phrase consensual observation to refer to the same phenomenon. The process in which the expression of emotion by one member stimulates the awareness of a similar emotion in another member. The group recreates the family of origin for some members who can work through original conflicts psychologically through group interaction (eg, sib ling rivalry, anger toward parents). The capacity of a group member to put themselves into the psychological frame of reference of another group member and thereby understand their thinking, feeling, or behavior An unconscious defense mechanism in which the person incorporates the characteristics and the qualities of another person or object into their ego system ( continued )

Psychotherapies

Acceptance

Altruism

Catharsis

Cohesion

Consensual validation

Contagion

Corrective familial experience

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Empathy

Identification