16Groups and

Change

The usefulness of groups is nowhere more apparent than when groups are used to help their members change. Groups, by their very nature, provide their members with information, support, and guidance, and so many personal and interpersonal problems can be resolved when confronted in a group rather than alone. As Lewin’s Law suggests, changing people one by one is difficult; changing them when they are part of a group is easier.

What are some of the ways that groups are used to help members change?

How do groups promote change?

How effective are groups in bringing about change?

Group Approaches

Therapeutic groups

Interpersonal learning groupsSupport groups

Sources of Change

Universality & hope

Social learning

Cohesion

Disclosure & catharsis

Altruism

Insight

Effectiveness

Empirical support

Cautions

The value of groups

Case: The Bus Group(Turner, A. L., 2000).

Lewin’s Law of Change

“It is usually easier to change individuals formed into a group than to change any of them separately.”

Therapeutic groups

Interpersonal learning groups

Support groups (mutual help groups)

Basic “types” of therapeutic groups

Group Psychoanalysis

Gestalt Groups

Psychodrama

Interpersonal Group Psychotherapy

Cognitive-behavioral therapy groups

Therapeutic groups

Types

Group Psychoanalysis

Freud’s discussed group processes in his book Group Psychology and the Analysis of Ego

Freud did not conduct therapy in groups, but other analysts did

Insight into unconscious conflicts

Transference of relationships to group members and therapist

[Source: Berlin, 1922 Becker Maas, Library of Congress (124),(LC-USZ62-119779)]From Left to Right: Otto Rank, Sigmund Freud, Karl Abraham, Max Eitingon, Sàndor Ferenczi, Ernest Jones, Hans Sachs

The First Committee Of The Vienna Psychoanalytical Society

Corrective recapitulation of early experiences

Catharsis

Gestalt Group Psychotherapy

Gestalt group therapy is based on the work of Fritz Perls, who maintained people tend to fail to accept and integrate their experiences, thoughts, and emotions

The Goal: To achieve phenomenological unity (a gestalt)

When conducted in groups, Gestalt therapy makes use of exercises and role‑playing methods (e.g., the hot seat, empty seat).

Psychodrama

Jacob Moreno developed this method; he also explored early uses of social network analysis (sociometry) and founded the journal Sociometry (now titled Social Psychology Quarterly).

Psychodrama involves acting out experiences in the group, role-playing, and imitation

Interpersonal Group Psychotherapy

The most widely used method, interpersonal group therapy, uses the group as a “social microcosm” to help members learn about how they influence others and how others influence them.

Irvin Yalom’s interactive process groups, for example, emphasize analysis of ongoing interactions in the group (a “here and now” orientation) by all members

Cognitive‑behavioral therapy groups

Cognitive-behavior group therapy uses of behavioral methods developed in individual treatment settings with groups.

Often used for more specific issues, such as phobias, depression, drug addiction, sexual offenses, and so on.

Key Components:

Behavioral contracts, modeling, behavior rehearsal, feedback

Process debriefing groups (or

critical incident stress

debriefing groups, or

trauma/disaster groups)

Process Debriefing Groups

Purpose: To reduce the negative mental health consequences of organizational-level or community-level trauma

Processes: Group-level therapeutic coping processes, such as collective processing of experiences and reaffirmation of connections to survivors.

Effectiveness: The effectiveness of these interventions is not yet known

Interpersonal learning groups

Early Forms

• T-groups (Lewin)

• Encounter groups

• Sensitivity training groups

Contemporary Approaches

• Experiential learning

• Skill-building retreats

• Structured training groups

Workshops, seminars, retreats, focusing on specific interpersonal skills or problems, often combine a group experience with analysis and reflection.

Problem-specific: deal with a specific problem or

concern, such as alcohol, physical illness

Interpersonal: members

establish strong ties to each

other

Communal: group stresses community and

sharing

Autonomous: little or no fee is charged for

membership, and leaders are

volunteers rather than professionals

Perspective-based: Often adopt

a particular “perspective” on the issue and its causes (e.g., AA)

Support groups

Varieties of Support (Mutual help) Groups

Many support groups meet online, relying on computer-based communication to make connections among members and provide information.

Group Approaches

Therapeutic groups

Interpersonal learning groupsSupport groups

Sources of Change

Universality & hope

Social learning

Cohesion

Disclosure & catharsis

Altruism

Insight

EffectivenessTherapeutic Factors

• Groups (and social comparison) convince members of the universality of their problems, elevate their levels of hope, and instigate a shared, group-level identity.

Universality and Hope

• Groups facilitate observational learning (modeling of behaviors), interpersonal feedback, and guidance (direct instruction).

Social Learning

• Cohesion increases membership retention, improves communication, and increases influence of the group on the individual.

Group Cohesion

Therapeutic Factors

• Groups become more intimate as members reveal private information about themselves.

Self-disclosure

• In supportive, high-trust groups, members can vent their strong, and this may reduce their stress.

Catharsis

• Members experience increased self-confidence when they help others and they gain insight into their personal qualities.

Altruism

Therapeutic Factors

Cohesion is generally viewed as a necessary condition for a successful thereapeutic group

However, members most value universality, interpersonal learning, cohesion/support, and insight

Sources of Change

Group Approaches

Sources of Change Effectiveness

Empirical support

Cautions

The value of groups

• Clinical procedures whose effectiveness has been documented through objective, scientifically rigorous research

Evidence-based Treatments (EBTs)

• Research indicates that group approaches to treatment are generally as effective, if not more effective, than individual approaches.

Are Group Treatments EBTs?

Source: http://www.apa.org/monitor/2012/11/power.aspx

Meta-analytic reviews are generally positive (Burlingame)

Lieberman, Yalom, & Miles‘ classic study supported various methods

Participants in many types of therapies rate groups approaches positively

Interventions are more effective if consis-tent with both the emic and etic perspec-tive of a cultural context

Empirical support

Drop-outs (premature terminations, casualities (individuals harmed by the experience, and overhelping occur in groups, but the rates are known to be relatively low

Cautions

Groups help their members define and confirm their values, beliefs, and identities. When individuals are beset by problems and uncertainties, groups offer reassurance, security, support, and assistance. Groups are places where people can learn new social skills and discover things about them-selves and others.

Group approaches are generally effective, but they do not work for everyone or for all types of psychological problems.

Groups, too, can produce changes in members when other approaches have failed

The value of groups

Group Approaches

Therapeutic groups

Interpersonal learning groupsSupport groups

Sources of Change

Universality & hope

Social learning

Cohesion

Disclosure & catharsis

Altruism

Insight

Effectiveness

Empirical support

Cautions

The value of groups

Case: The Bus Group(Turner, A. L., 2000).