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Chapter 15

Clinical Psychology Chapter 15.docx

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John Stephens

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Chapter 15- Group Therapy, Family Therapy, and Couples Therapy Group Therapy • Historically, applied – When heavy caseloads exist – As a supplemental technique • Spiked with veterans post World War II – Post traumatic stress disorder • Think of it in two different aspects – Approximation of therapy in a group setting – Cycle educational • Deemphasizes personal dimensions • Group Analytic Psychotherapy • Psychodrama (Moreno) • Transactional Analysis (Eric Berne) • Behaviour Therapy in Groups • Humanistic Group Therapy – t – groups Group Therapy Approaches • Psychoanalytic – Free association – Transference – Interpretation of resistance – Group as a vehicle • Increased anxiety tolerance • Psychodrama – Form of role playing – Seeks catharsis – Done in a theatrical play format • Transactional Analysis (TA): interactions among people of the group analyzed – 3 ego states • Child (id) • Parent (ego) • Adult (superego) • Each has a positive & negative aspects that patients can exhibit – Emphasis on games: behaviours used to avoid getting close to others – Lack of research – Biggest area is team development • Gestalt – Residential seminars, retreats, workshops – Focus on 1 member at a time – “Hot seat” approach – Lacking research • Behavioural – Efficiency over group dynamic to be more broad based – Reinforcement & problem solving (building skill sets) • Stress management – Therapist in didactic role – Time-limited – Research supported Group Therapy Arrangements • Common factors – 5-10 members – 90 minute to 2 hour sessions – Weekly • Can be mixed gender or separated • One or more therapists – Can also be gender diverse • Open vs. closed groups – Open ended i.e. this is wen we meet every week so come if you can • Closed groups – These people have signed up so you come at this time everyday • Group confidentiality • Curative factors – Imparting information – Instilling hope – Universality – Altruism – Interpersonal learning – Imitative behaviour – Corrective recapitulation – Catharsis • Public and private – Group cohesiveness • Does it work? – More efficient & economical – More effective than no treatment – Not shown to be superior to other treatments – Needs further research • Looking ahead – Increasing demand – Influence of managed care – Alternative to inpatient treatment Family Therapy • Background – Rooted in social work – Influencing individuals through the whole family unit; one person’s problem affects all members – Usually go to treatment because of the black sheep in the family which is usually one of the siblings – Some siblings are often portraying a pathological balance in the family • Double bind concept: A case in which an individual is told two contradictory messages by an important figure in his or her life such that every response he or she makes with regard to that figure is wrong • Influence of schizophrenia studies: identified pathologic families • Communication – Pathology is failure of communication – General systems theory: the family is a system, and pathology is reduced by altering the way the system functions – Focus on “unbalanced” state • Forms/ methods – Multiple professions/ practitioners
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